Billing Specialist - Insurance Collections Specialist

Job Description:

Job Details

Job Location Midtown - Elite - Nashville, TNRemote Type Fully RemotePosition Type Full TimeSalary Range $19.00 - $21.00 Job Shift Day

The Insurance Collections Focused Specialist job is to focus on working aging reports (specifically from our Alpha insurance list) and maintain insurance correspondence, answer billing line, and other duties as needed to support the billing department and customer service. 

Please be aware that this position is REMOTE, but you must live in the state of TN. You can't live out of state and work this position remotely. 

Elite Sports Medicine + Orthopedics offers a competitive compensation package for full-time members including: Three Medical Plans Options (your choice of a PPO or HDHP), Dental and Vision Coverage, Health Savings Account (with HDHP), Employee Assistance Program, Company Provided Basic Life, AD&D and Long-Term Disability, Voluntary Life and Short-Term Disability, PTO Accrual, Paid Holidays, and 401(k) + employer match.

MINIMUM ESSENTIAL JOB REQUIREMENTS

• Work Insurance Aging with a focus of 61 days and older aged accounts
• Properly communicate and document denials in the practice management system
• Follow the guidelines set in the practice management system for follow up on claim statuses and follow up dates
• Submit replacement claims, reconsiderations, and appeals for denied claims
• Research and resolve outstanding claim issues
• Identify any payments not being paid at the allowed/contract amount and communicate to your supervisor
• Review payer specific communication and update necessary team members and departments
• Identify trends in denials and communicate to your supervisor
• Respond to written and telephone billing inquiries from patients related to insurance processing
• Process requests for refunds and submit for approval
• Contact insurance companies for outstanding balances and communicate as necessary for resolving outstanding and unpaid claims
• Respond to written and telephone billing inquiries from patients
• Resubmit insurance claims as needed and submit appeals/reconsideration documentation
• Help answer the billing line phone and assist patients regarding their account information
• Promote the company website and patient link resources by communication to the patients that they can pay their bill online
• Other miscellaneous tasks delegated by manager

KNOWLEDGE, SKILL AND COMPETENCY REQUIREMENTS

• High school diploma required
• College education or trade school preferred
• Experience working in a physician office or hospital billing-type position preferred
• Proven record of discussing financial responsibilities and establishing payment plans when necessary
• Comfortable using email and interacting various applications
• 3 to 5 years of collection experience, preferably BCBS
• Knowledge of Billing and Collections procedures
• Knowledge of CPT and ICD-10-CM coding
• Orthopedic claims experience is preferred
• Knowledge of MS Office Suite
• Ability to work standard office equipment (fax, copier, telephone, computer)
• Knowledge of managed care, commercial insurance, Medicare and Medicaid reimbursement
• Proven understanding of Explanation of Benefits forms, claim forms and the insurance billing process
• Demonstrate proficient use of billing and scheduling applications within the software
• Excellent written and verbal communication abilities
• Strong attention to detail and goal-orientated
• Neat, professional appearance

We are an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, national origin, sex, sexual orientation, age, disability, gender identity, marital or veteran status, or any other protected class.