Insurance Claims Specialist

$43,680 - $47,840/Yr

Blackstone Medical Services - Tampa, FL

Full-time - Entry Level

Tampa, FL

Ambulatory Health Care Services

About the position

We are seeking a skilled and detail-oriented Medical Insurance Claims Collector to join our team. The ideal candidate will be responsible for reviewing, analyzing, and adjudicating medical claims in compliance with company policies, industry standards, and applicable regulations. This role involves investigating claims, ensuring accurate payment, and addressing any discrepancies or denials.

Responsibilities

• Manage accounts receivable by tracking claims payments and following up on and working denied claims.
• Utilize medical terminology to communicate effectively with clients regarding their accounts.
• Engage in revenue cycle management practices to optimize collections processes.
• Perform account reviews to ensure accuracy in billing and payment records.
• Demonstrate excellent phone etiquette while negotiating payment arrangements with clients.
• Maintain detailed records of all communications and transactions related to account collections.
• Collaborate with team members to develop strategies for improving collection rates.
• Analyze supporting documentation, including medical records and coding, to determine claim validity.
• Investigate and resolve claim discrepancies, denials, and appeals efficiently.
• Communicate with providers, policyholders, and internal teams to clarify claim-related issues.
• Stay updated on industry regulations, medical billing codes, and payer policies.
• Maintain detailed records of claims activity and ensure adherence to confidentiality standards.

Requirements

• Claims denial management experience and success in overturning the denial.
• Proficient in account analysis and understanding of accounts receivable processes.
• Familiarity with medical terminology and medical billing practices.
• Strong knowledge of revenue cycle management principles.
• Ability to effectively negotiate payment terms while maintaining professionalism.
• Competence in handling debits and credits accurately within financial systems.
• Excellent communication skills, particularly over the phone, ensuring clear and respectful interactions with clients.
• Detail-oriented with strong organizational skills for managing multiple accounts simultaneously.

Nice-to-haves

• Motivated individuals who are eager to learn and grow within the organization.

Benefits

• Dental insurance
• Health insurance
• Paid time off
• Vision insurance