Medical Insurance Collection Specialist
$41,600–$45,760 year
On-site · Tarpon Springs, Florida, United States
Job Summary
Follow up on outstanding, unpaid, and underpaid insurance claims to ensure timely reimbursement, utilizing electronic billing systems, phone outreach, and written correspondence. Investigate and resolve claim denials, rejections, and payment discrepancies by analyzing EOBs, remittance advices, payer policies, and account documentation. Prepare and submit corrected claims, appeals, and supporting documentation to insurance carriers in accordance with payer requirements and regulatory guidelines. Maintain accurate records of claim activity, payment status, and collection efforts within billing software and EMR systems to support compliance and audit readiness. Collaborate with insurance representatives, patients, coding, billing, and patient services teams to resolve complex account issues and maximize revenue cycle performance.
Required Qualifications
- Must understand medical insurance including deductibles
- Must have experience with verifying Medicare, Medicaid, and major commercial health insurance and secondary payers
- Experience with referrals and prior authorization
- Medical terminology and ICD-10
- Must be MS Office proficient including Excel
- High school diploma or equivalent
- Background check required
Desired Qualifications
- MS Office proficiency including Excel
- Experience with referrals and prior authorization
- Medical terminology and ICD-10 knowledge
- Understanding of Medicare, Medicaid, and major commercial health insurance as well as secondary payers
- Experience with verification of benefits and payer policies
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