Medical Insurance Collections Specialist

hace 3 semanas


Tijuana, México USA Clinics Group A tiempo completo

We are seeking an experienced and highly detailed **Medical Collections Specialist** to join our Revenue team. The Medical Collection Specialist is the primary source for managing patient’s delinquent accounts including sending patients to collections. This position will hold the responsibility of arranging repayment agreements with the patient and assisting in other parts of the billing office as needed.

**Duties and Responsibilities**:

- Contacting Insurance regarding claim status, denials, underpayments, and recoupments
- Be able to read and understand insurance eligibility and benefits
- Familiar with provider portal eligibility and claim tools. Example: Availity, Navinet
- Research & resolve outstanding claim issues and patterns
- Be able to read and understand insurance remittance including denial and remark codes
- Submit Appeals for Denied Claims
- Submit Medical Records and other documentation requests to insurance
- Understands the remittance denial codes and know how to get claims reprocessed
- Ability to work on 40+ denied claims per day on the phone and provider portals
- Experience with Aetna, BCBS, UHC, Medicare, and Medicaid denials
- Experience with multi state insurance denial collecting a plus
- Experience using Excel is a plus
- Experience with denials for Varicose veins, and/or Dialysis is a plus
- Strong personality and willingness to argue with insurance claims representatives to overturn denials

**Requirements**:

- Understands the remittance denial codes and know how to get claims reprocessed
- Ability to work on 40+ denied claims per day on the phone and provider portals
- Experience with Aetna, BCBS, UHC, Medicare, and Medicaid denials
- Experience with multi state insurance denial collecting a plus
- Experience using Excel is a plus
- Experience with denials for Varicose veins, and/or Dialysis is a plus
- Ability to successfully manage different personalities in regards to insurance claims representatives to overturn denials
- Maintain 100% confidentiality relating to all patients, corporate, financial and proprietary information

**Benefits**
- IMSS 100%
- Vacations (after the first year)
- Christmas bonus
- Paid Training
- Weekends off
- Mexican Holidays off
- You will also be eligible for any additional employee benefits that the company may provide in the future.



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