About This Role
The Billing Specialist focuses on reviewing and evaluating insurance denials or returned claims, communicating with insurance companies and clients to resolve issues. This role involves thorough research, collection efforts, sending medical records, and drafting appeals for denied claims.
Responsibilities
- Deliver exceptional customer service to clients while maintaining strict adherence to HIPAA privacy and confidentiality standards
- Precisely and comprehensively document all relevant information and follow-up actions in the electronic records system
- Monitor and follow up on processed claims to ensure timely and accurate payment to the agency
- Collaborate directly with insurance payers to confirm client eligibility and determine financial responsibility, including co-pays, deductibles, co-insurance, and out-of-pocket maximums
- Pursue follow-up actions on insurance denials, including initiating appeals and requesting reconsiderations as appropriate
- Support all billing-related tasks and responsibilities tied to both insurance and client invoicing, as needed
- Investigate rejected insurance claims thoroughly and take appropriate action to reprocess or appeal denied or underpaid claims
- Detect and analyze patterns in claim denials, escalating persistent payment delays or systemic issues to senior management
- Communicate with insurance companies to resolve outstanding account balances and expedite claim resolution
Requirements
- Proven experience in medical collections or accounts payable/receivable is preferred
- Strong understanding of financial concepts, accounting principles, and revenue cycle management
- Excellent phone etiquette with the ability to communicate effectively with clients
- Proficiency in financial software and accounting software for managing accounts
- Knowledge of debits, credits, and account analysis is essential
- Strong math skills for calculating payments, balances, and adjustments
- Ability to work independently while managing multiple accounts efficiently
- A commitment to maintaining confidentiality and compliance with industry regulations
- 1 year of collections experience (Required)
Benefits
- 401(k) matching
- Dental insurance
- Health insurance
- Vision insurance
- Paid time off
About the Company
FloMed Infusion is an outpatient infusion clinic offering Medical Infusions and Injections in a relaxing ambulatory environment.
