Medical Insurance Collector

Position Summary:

The Medical Insurance Collector is responsible for managing accounts receivable (A/R) to ensure timely and accurate payment from insurance carriers. This role focuses on resolving outstanding claims, handling denials and rejections, and ensuring compliance with insurance guidelines and regulations. The ideal candidate will have experience with insurance portals, appeals, and gastroenterology billing, as well as the ability to work collaboratively in a team environment.

Job Details:

Medical Insurance Collector

Work from Home

Monday to Friday | 9 PM to 6 AM (PH Time)

*Following US Holidays

Responsibilities:

• Work on outstanding A/R to secure payments from insurance carriers.

• Utilize insurance web portals to upload appeals and supporting documents.

• Analyze and interpret Explanation of Benefits (EOBs) to identify payment discrepancies.

• Ensure claims are reimbursed at the correct contracted rates.

• Address and resolve claim rejections and denials efficiently to expedite payment.

• Prepare and submit detailed appeals to insurance carriers when necessary.

• Maintain a thorough understanding of insurance carrier guidelines, including those for government and commercial payers.

• Collaborate with the billing team to meet department goals and deadlines.

Qualifications:

• Minimum of two (2) years’ experience in medical billing and collections.

• Familiarity with GMed software and gastroenterology billing processes is an advantage.

• Comprehensive knowledge of insurance guidelines, regulations, and payer-specific products.

• Proficiency in reading and interpreting EOBs.

• Demonstrated ability to work effectively with government and commercial payers.

• Strong skills in writing and submitting appeals.

• Ability to work effectively in a collaborative, team-oriented environment.