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Insurance Collections Specialist

Genesis Healthcare Partners

Insurance Collections Specialist

San Diego, CA
Full Time
Paid
  • Responsibilities

    Job Description

     

    Genesis Healthcare Partners was created to bring together a group of San Diego's leading Urologist and leading experts in radiation therapy for cancer, and Gastroenterologists. This multi-specialty organization is located in more than 14 locations within San Diego County. Our Administrative office has an immediate opening for a full time qualified Insurance Collections Specialist, who can provide exceptional customer service, and demonstrate their ability work on a proactive team and to communicate with insurance companies, physicians, medical group representatives, and patients in a professional, courteous, and helpful manner. This position must have the necessary skills to review claims 60+ days past due and perform patient financial counseling. Familiarity with coding for surgical procedures rendered by multiple gastroenterology, radiation oncology and urology providers in office and hospital settings. Reviewing claims appeals prior to submitting them to payers, verifying documentation & diagnosis, adding modifiers, linking to payers, linking to authorizations, verifying provider information, etc. Perform post payment reviews as necessary to meet compliance requirements.  Work with fellow Revenue Cycle Team members to share information and improve processes. Correct medical claims and re-billing if necessary. Submit appeals to Medicare and other payers for denied or incorrectly paid charges. Manage credit reports and process refund requests for over-payments. Assessment tests on Medical billing/collections, Excel may be administered as part of the recruitment process. Required Qualifications: • Experience with medical billing software, financial ledgers, and aging reports. • Knowledge of appeal procedures for Medicare and other payers • Experience with electronic claims submission procedures and the use of Practice Management software • Knowledge of basic medical billing terms and procedures • Knowledge of basic insurance health plans and medical documents • Knowledge of basic skills in computer software programs such as Excel, Word, and Outlook • Extensive knowledge of local HMO/PPO/IPA, etc. Preferred Qualifications:

    • Bilingual Spanish                                                                                                                                                            • Coding familiarity • Experience with Urology, Radiation Oncology, Lab, and Gastroenterology Billing and Collections • Experience with Allscripts PM and Clinical • Experience with electronic medical records (EMR) • Additional classes and training in medical billing and collections desired Educational Requirements: • High School Diploma, G.E.D., or equivalent Minimum Experience: • 3 or more years of prior medical billing and collections experience