Insurance Collection Specialist

Posted On: 11/20/2019

SUMMARY: Under the direction of the Business Office Manager, the Insurance Collection Specialist is responsible for handling the billing and collections for various provider and services. Insurance Collector ensures that claim payments are received in a timely fashion and accurate manner. Participates in a team environment to include open communication, trust, accountability and mutual respect.

EDUCATION and/or EXPERIENCE: Minimum requirements include:

  • High school diploma or equivalent.
  • Two years prior of medical collections experience with a medical group is preferred but not required.
  • Knowledge of medical practice billing/collection functions.
  • Knowledge of basic medical coding and third-party operating procedures and practices. Knowledge of legal and regulatory government provisions.
  • Must be proficient in computer related skills, MS Office preferably in Excel and Word.
  • Ability to work with limited supervision; possess strong verbal communication skills, good organization skills and attention to detail.
  • Experience with Nextgen practice management a plus.

JOB QUALIFICATIONS: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.



ESSENTIAL DUTIES AND RESPONSIBILITIES (Duties include the following, but are not limited to)

Submission of accurate, clean claims to payers.

  • Verification of accuracy of coding and billing information for claims submitted.
  • Identification of delinquent claims via various system tools and specified process for claims follow-up for multiple providers assigned.
  • On-going research of payer policy and submission guidelines.
  • Resubmission and appeal of claims as required.
  • Adherence to DMA Compliance Policy as it relates to all matters of billing and collection.