Job Description

The Accounts Receivable Insurance Collector is responsible for the timely follow-up and resolution of insurance claims. This role ensures accurate and efficient collection of outstanding balances from insurance payers, working to reduce aging accounts receivable and increase cash flow for the organization. This position is a Medicaid insurance associate on the revenue cycle management team. Responsibilities include reviewing aging reports and working insurance accounts to ensure timely resolution and reimbursement; contacting insurance companies via phone, portals, or email to check claim status, request reprocessing or escalate issues; analyzing denials and underpayments to determine appropriate action (appeals, corrections, resubmissions); tracking and following up on all submitted appeals until resolution; analyzing explanation of benefits (EOBs) and remittance advice to determine the reason for denial or reduced payment; documenting all collection activities in the billing system according to departmental procedures; following up on unpaid claims within payer-specific guidelines and timelines; coordinating with other billing team members, coders, and providers to resolve claim discrepancies; maintaining up-to-date knowledge of payer policies, coding changes, and reimbursement guidelines; ensuring compliance with HIPAA and all relevant federal/state billing regulations; flagging trends or recurring issues for team leads or supervisors; meeting daily/weekly productivity goals; and assisting with special projects, audits, or other duties as assigned. Qualifications include 1-3 years of experience preferred, High School Diploma or GED preferred, strong knowledge of insurance claim processing and denial management preferred, familiarity with Medicare, Medicaid, and managed care preferred, proficiency in billing software and Microsoft Office Suite, excellent verbal and written communication skills, ability to work independently and manage time effectively, and detail-oriented with strong analytical and problem-solving skills.

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