Collections Specialist

Required Skills & Experience

• High school diploma or equivalent education.
• 3-5 years of experience in hospital billing and collections
• Back-end rev cycle Epic experience
• Intermediate knowledge of UB-04 and Explanation of Benefits (EOB) interpretation.
• Intermediate knowledge of CPT and ICD-10 codes.

Nice to Have Skills & Experience

• Front end insurance verification experience

Job Description

Insight Global is looking for Collections Specialist to support one of their large healthcare clients in the bay area. Below is the job description:

Responsible for managing follow-up and collections on outstanding insurance balances, including contacting payers and patients, reviewing payer websites, verifying claim status and adjudication, and determining appropriate next steps for each account. Duties include resolving denials and billing issues, submitting claims and supporting documentation, handling aged and high-priority accounts, maintaining accurate account notes, and identifying payer or system trends that may require escalation.

Also responsible for reviewing billing documentation for compliance with Medicare, Medi-Cal, Mental Health, and commercial insurance requirements, reconciling account balances and payments, maintaining operational records, and preparing reports. Communicates escalated payer and account issues to management and participates in ongoing training and performance evaluations.