Insurance Collector II - ASC

Connecticut Orthopaedics has been named as the #1 Physician Practice in Orthopaedics in Connecticut, as well as ranking in the Top 3 for Surgical Care and the Top 5 for Overall Physician Practices across the state by Castle Connolly.

Do you want to join the Home to the Best Orthopaedic Doctors in Connecticut?

Connecticut Orthopaedics is looking for an Insurance Collector II for our Wallingford office.

• Please note that we will not reach out to any candidate that does not have a minimum of 2 years of medical billing experience.

• Monitor and resolve EDI dashboard for claim kick-out edits
• Manage A/R thru system module and reports
• Process simple denials, resubmit, appeal and follow-up on unpaid/incorrectly processed claims
• Work with Coding department to resolve claim rejections and appeals
• Answer incoming insurance specific inquiries
• Process basic insurance follow-up on claims
• Communicate with insurance carriers for claim status and collect on accounts
• Handle any Worker’s Compensation claims, rejections and appeals
• Handle more complex insurance denials and appeals
• Escalate unresolved claims to Leads or Supervisor timely
• Attend coding training/review sessions to share knowledge with team
• Assist with training new Level I Insurance Collectors
• Identify trends in denials and propose solutions
• Assist with process improvement to bring about greater claims resolution
• Ensure the quality, integrity, and proper work effort of assigned tasks
• Perform other tasks and related work as required
• Follow all Connecticut Orthopaedics policies and procedures including but not limited to Human Resources, administrative, and HIPAA compliance
• Perform other duties as assigned by their supervisor

• Strong knowledge of insurance adjudication process
• Strong ability to communicate well with insurance companies and co-workers
• Demonstrate initiative and ability to multi-task while working independently
• Strong organizational skills and systems aptitude
• Solid computer skills including proficiency with Microsoft 365
• Ability to work well with peers
• Ability to problem-solve and think proactively on how an insurance change or trend is/can affect insurance payments

• EDUCATION:
  
  High School Diploma or GED required, Associate’s Degree or higher preferred
• EXPERIENCE:
  
  Five plus years of experience with medical insurance collections, worker’s compensation surgeries particularly or an equivalent combination of five years’ experience and education required. EMR experience with Epic and Amkai preferred. Prior knowledge of CPT/modifiers and ICD-9/ICD-10 codes. Experience with insurance websites such as Availity and knowledge of MS 365 is a plus.
• LICENSURE: CPC certification is preferred.