Billing/ Insurance Collections Analyst

Description

Remote is capable --

We’re a medical billing company knee-deep in the wild world of workers’ compensation pharmacy claims. If you’ve ever wondered what happens after prescriptions are dispensed, billed, denied, underpaid, and sent back with cryptic codes — you’re our kind of person. We need an Insurance Analyst/Collector who can chase payments like it’s a sport, decode denial reasons like ancient hieroglyphics, and still stay (mostly) sane.

The Billing/Insurance Analyst is responsible for conducting follow-up on outstanding claims, gathering additional information requested, and basic billing functions, including claim corrections, resubmissions, and appeals. Meets department targets regarding productivity and claim resolution and re-submits claims as needed. Assisting with follow-up requests from payors and evaluating unresolved workers comp claims to facilitate resolution. Billing/Insurance Analysts at Claimpay, Inc. are a specific subset of collectors and specialize in all debts relating to Workman’s Compensations patients who receive in office dispensed medication.

What You’ll Actually Do (Besides Leaving Voicemails)

• •Follow up with carriers, TPAs, and adjusters who claim, “we paid that last week” (spoiler: they didn’t).
• •Review EOBs and decipher denial codes ranging from “non-use of PBM card” to “because we said so.”
• •Collect payments that mysteriously got reduced to “contract rates” we’re not even part of.
• •Prepare appeal letters that cite state fee schedules and make payors sweat a little.
• •Document every conversation — because if it’s not in writing, it didn’t happen.
• •Perform “other duties as assigned,” usually involving more phone calls, emails, and maybe carrier hold music.

Requirements

Qualifications

High School Diploma or equivalent;

2 years of office experience in medical billing / collections preferred.

Must possess knowledge of Explanation of Benefits (EOB’s) and understanding of copays-insurance, deductibles, and denial codes.

Attention to detail and have the ability to prioritize independently.

The ability to multi-task and in a busy office environment.

Proficient customer service skills.

Intermediate knowledge of MS Office.

Knowledge of medical billing/collection practices.

Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals.

Ability to write routine reports and correspondence.

Ability to speak effectively before groups of customers or employees of an organization.

Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.

Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form.

Ability to deal with problems involving several concrete variables.

Perks of Working Here

• •Job security: insurance companies will always find new ways to underpay.
• •The unmatched satisfaction of getting carriers to pay what they actually owe.
• •A crash course in state fee schedules (you’ll be quoting O.C.G.A. and T.C.A. in your sleep).
• •Coffee, camaraderie, and coworkers who understand your carrier-related rants.
• •Unlimited exposure to the sweet sounds of hold music.

Key Competencies:

INTENSITY!

Interpersonal skills

Communication skills -verbal and written

Listening skills

Problem analysis and problem-solving

Adaptability

Initiative

Stress tolerance