Gastro Health is a healthcare provider focused on digestive and gastrointestinal care for adults and children. Its services span diagnostic procedures such as colonoscopy, endoscopic ultrasound, and flexible sigmoidoscopy, as well as treatment for conditions including heartburn, Crohn’s disease, and ulcerative colitis. Care is delivered through a network that includes surgery and infusion centers, specialty pharmacies, telehealth, and nutrition therapy. The organization also offers colorectal surgery and endoscopic weight-loss services.
Senior Insurance Collections Specialist
Lead insurance collections, denial resolution, and accounts receivable work while supporting Gastro Health’s nationwide gastroenterology network. Resolve claims and coach team members.
विवरण
- Lead the insurance collections team and oversee accounts receivable management.
- Resolve insurance claims promptly and accurately, addressing denials and underpayments.
- Act as a subject matter expert and handle first-level escalations.
- Improve workflows and mentor colleagues.
- Resolve complex claims and payer issues.
- Contribute to training, audits, reporting, and process improvement.
- Partner with management on revenue cycle goals and compliance with policy changes.
- Coordinate communication among healthcare providers, patients or responsible parties, and revenue sources.
- Follow up with insurance and third-party carriers until accounts are paid.
- Seek payment on current and overdue accounts by phone and in writing.
- Update patient account records.
- Track payer denial patterns and problem accounts, and report trends to the supervisor.
- Prepare monthly aging reports by date of service and current accounts receivable.
- Work assigned insurance queues each day.
- Apply company-approved collection practices to resolve accounts.
- Refer coding-related denials to the Coding Specialist.
- Send faxed information, request retroactive authorizations, and verify medical eligibility.
- Investigate claims to confirm appropriate reimbursement.
- Support special projects assigned by the Billing Manager or Supervisor.
आवश्यकताएँ
- Experience supporting a growing healthcare organization with at least 100 providers and overseeing a team of 10 or more.
- At least three years of insurance collections experience.
- Experience with large healthcare billing systems serving more than 100 providers is preferred.
- Knowledge of medical terminology used in collections and billing, including CPT, ICD-10, and HCPCS.
- Knowledge of appeal letters.
- Intermediate proficiency with Microsoft Excel and Office applications.
- Experience with HMO, PPO, and Medicare plans.
- At least five years of experience in the healthcare industry.
- At least one year of supervisory or team leadership experience in healthcare revenue cycle roles covering all phases of revenue cycle management.
- Ability to read, interpret, and apply regulations, policies, and procedures.
लाभ
- Work-life balance.
- Monday through Friday schedule with no evenings or weekends.
- Paid holidays and paid time off.
- Advancement opportunities.
- Competitive compensation.
- Medical coverage.
- Dental coverage.
- Vision coverage.
- Spending accounts.
- Life and accidental death and dismemberment coverage.
- Disability coverage.
- Accident coverage.
- Critical illness coverage.
- Hospital indemnity coverage.
- Legal coverage.
- Identity theft coverage.
- Pet coverage.
- 401(k) retirement plan with a non-elective Safe Harbor employer contribution for eligible employees.
- Discretionary profit sharing, with employer contributions of 0% to 4% for eligible employees.
- Tickets at Work discounts on concerts, travel, movies, and more.