Billing/ Insurance Collections Analyst

Remote is capable -

We’re a medical billing company knee-deep in the wild world of workers’ compensation pharmacy claims. If you’ve ever wondered what happens after prescriptions are dispensed, billed, denied, underpaid, and sent back with cryptic codes — you’re our kind of person. We need an Insurance Analyst/Collector who can chase payments like it’s a sport, decode denial reasons like ancient hieroglyphics, and still stay (mostly) sane.

The Billing/Insurance Analyst is responsible for conducting follow-up on outstanding claims, gathering additional information requested, and basic billing functions, including claim corrections, resubmissions, and appeals. Meets department targets regarding productivity and claim resolution and re-submits claims as needed. Assisting with follow-up requests from payors and evaluating unresolved workers comp claims to facilitate resolution. Billing/Insurance Analysts at Claimpay, Inc. are a specific subset of collectors and specialize in all debts relating to Workman’s Compensations patients who receive in office dispensed medication.

What You’ll Actually Do (Besides Leaving Voicemails)

• Follow up with carriers, TPAs, and adjusters who claim, “we paid that last week” (spoiler: they didn’t).
• Review EOBs and decipher denial codes ranging from “non-use of PBM card” to “because we said so.”
• Collect payments that mysteriously got reduced to “contract rates” we’re not even part of.
• Prepare appeal letters that cite state fee schedules and make payors sweat a little.
• Document every conversation — because if it’s not in writing, it didn’t happen.
• Perform “other duties as assigned,” usually involving more phone calls, emails, and maybe carrier hold music.

Qualifications

• High School Diploma or equivalent;
• 2 years of office experience in medical billing / collections preferred.
• Must possess knowledge of Explanation of Benefits (EOB’s) and understanding of copays-insurance, deductibles, and denial codes.
• Attention to detail and have the ability to prioritize independently.
• The ability to multi-task and in a busy office environment.
• Proficient customer service skills.
• Intermediate knowledge of MS Office.
• Knowledge of medical billing/collection practices.
• Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals.
• Ability to write routine reports and correspondence.
• Ability to speak effectively before groups of customers or employees of an organization.
• Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.
• Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form.
• Ability to deal with problems involving several concrete variables.

Perks of Working Here

• Job security: insurance companies will always find new ways to underpay.
• The unmatched satisfaction of getting carriers to pay what they actually owe.
• A crash course in state fee schedules (you’ll be quoting O.C.G.A. and T.C.A. in your sleep).
• Coffee, camaraderie, and coworkers who understand your carrier-related rants.
• Unlimited exposure to the sweet sounds of hold music.

Key Competencies:

• INTENSITY!
• Interpersonal skills
• Communication skills -verbal and written
• Listening skills
• Problem analysis and problem-solving
• Adaptability
• Initiative
• Stress tolerance