Insurance Collections Analyst (32714)

The Insurance Collections Specialist is responsible for performing all aspects of insurance duties, to include verifying insurance coverage, filing insurance claims, collection duties, filing Workers' Compensation claims, entering payments with corresponding explanation of benefits (EOB's), filing appeals, general Accounts Receivable support and answering the phone. In addition, the Patient Financial Services Rep must be able to provide efficient and proficient services to our physicians as well as provide quality, courteous and compassionate services to our patients in adherence to the guidelines, policies and procedures set forth by The Conrad Pearson Clinic.

ESSENTIAL JOB FUNCTIONS

• Verify and file insurance and Workers' Compensation claims.
• Follow-up on all pending insurance claims.
• Assist with setting up payment agreements and process patient payments over the phone or by mail.
• Perform the daily billing process and work with the front-end rejections.
• Perform collection duties for outstanding patient balances which include collection of payment for nonsufficient fund checks.
• Post payments received with corresponding EOB's.
• Answer telephone calls regarding patient balances and insurance questions.
• Sort, read, answer and file correspondence.
• Perform all necessary corrections and adjustments to patient accounts.
• Complete the monthly work log in NextGen by assigned due date.
• Perform general clerical duties such as typing, faxing, distribution of faxes, shredding and photocopying.
• Act as liaison between physician office and insurance companies, providing additional information as requested.
• Communicate regularly with supervisor, keeping him/her apprised of all pertinent information and providing feedback.
• Ensure compliance for all regulatory requirements including OSHA, CLIA and HIPAA; immediately and accurately document and report occurrences to supervisor; and ensure compliance with all legal and regulatory requirements as outlined in the corporate compliance plan.
• Support and adhere to all company policies, procedures and management decisions; maintain confidentiality of patients' medical information; and all confidential administrative related issues.
• Demonstrate dependability in attendance, punctuality in reporting for work and initiative in completing a full work schedule; meeting or exceeding all established deadlines and utilizing all resources and supplies efficiently and appropriately.
• Demonstrate the ability to concentrate during the course of the day.
• Display a positive outlook with a helpful, constructive manner when working with other employees.
• Demonstrate superior patient relations and interpersonal skills; demonstrate an appropriate level of mental and emotional tolerance and even temperament when dealing with staff, patients and general public using tact, sensitivity and sound judgment; promote a positive work environment and contribute to the overall efforts of the department and the company.

POSITION REQUIREMENTS

• High School Diploma or GED equivalent is required.
• Two years of insurance, billing and collection experience is required, preferably in a physician office.
• Strong knowledge of ICD-10 and CPT coding is required.
• Computer experience is required.
• Excellent oral and written communication, interpersonal, problem-solving and organizational skills are required.
• Occasional overtime, evening and weekend work is required
• A valid driver's license, dependable automobile and current auto insurance are required for occasional travel for business purposes and to work at satellite locations.

ESSENTIAL PHYSICAL REQUIREMENTS

• Requires prolonged sitting, some bending, stooping and stretching, or performing other work requiring moderate physical exertion.
• Capacity to maintain physical activity over prolonged periods of time (stamina).
• Able to see for the purpose of reading information received in different formats including but not limited to paper, computer, reports, bulletins and manuals.
• Able to hear for work-related purposes.
• Requires eye-hand coordination and manual dexterity sufficient to operate a keyboard, photocopier, telephone, calculator and other office equipment.
• Able to lift up to a minimum of 25 pounds.

ESSENTIAL ENVIRONMENTAL CONDITIONS

• Work is generally performed under normal office working conditions.
• Normal level of visual strain.
• Ability to cope with stress caused by public interaction, multiple demands and extraneous noises.
• Possible exposure to contagious diseases.