Senior Insurance Collections Specialist

Gastro Health is seeking a Full-Time Senior Insurance Collections Specialist to join our team!

Gastro Health is a great place to work and advance in your career. You'll find a collaborative team of coworkers and providers, as well as consistent hours.

The Senior Insurance Collections Specialist is responsible for leading and supporting the insurance collections team in all aspects of accounts receivable management. This role ensures timely and accurate resolution of insurance claims, denial management, and underpayment trends to meet and exceed departmental goals and KPIs. The Senior Specialist serves as a subject matter expert, managing first-level escalations, streamlining workflows, and mentoring team members to enhance overall effectiveness. In addition to handling complex claims and payer issues, this role participates in training, audits, reporting, and process improvement initiatives. The Senior Insurance Collections Specialist works closely with management to support strategic RCM goals, ensure compliance with policy changes, and drive continuous operational excellence within the AR team

This role offers:

• A great work/life balance


• No weekends or evenings – Monday thru Friday


• Paid holidays and paid time off


• Rapidily growing team with opportunities for advancement


• Competitive compensation


• Benefits package

Duties you will be responsible for:

• Respond to any process related questions and manage 1st level escalations.
• Prioritize, assess, and re-prioritize daily workflows to ensure timely execution of AR and meeting/exceeding goals/KPI.
• Assist with creation of front-end scrubs/edits based on denial management review.
• Effectivity manages the team through streamlined improvement initiatives to ensure the team is highly effective for the
  providers.
• Participate in new project assignment and work towards proper transition of knowledge to team.
• Actively participates and maintains strong new hire training process and assists with policy/procedure documentation and
  process workflow.
• Conduct audits of team members to ensure quality initiatives are being met and exceeded.
• Identify and document trends in underpayments, denials, aging receivable that compromise the ability of the AR team to
  meet established goals.
• Assists with resolution of complex claims or projects and trains team to improve follow up efforts.
• Strong analytical skills to prepare project data with external payors and partners.
• Motivate, train, evaluate, record and report team members performance and progress
  
• System matter expert of all AR functions across the team to maintain a highly efficient and productive team and to ensure
  process can be trained effectively.
• Assist Management in establishing weekly/monthly goals, ensure AR team members are utilizing all resources and meeting and/or surpassing weekly/monthly KPI’s.
• Assist manager with preparing weekly and monthly RCM reporting metrics to remediate any items outside established KPI
  including status report of projects.
• Research and maintain understanding of policy changes across the RCM markets.
• Daily reviews of the following programs: Incoming claim/denial volumes, daily billing, rejections, evaluate clean claim rates, and team workflows.
• Assist manager in the interview process.
• Assist with preparation of team meetings focused on collaboration and process improvement.
• Assist Manager with employee performance appraisals and work with the accounts receivable team on skill development.

Minimum Requirements:

• High School Diploma/GED required
• Bachelor’s Degree preferred, but not required
• Certified Professional Biller (CPB)
• Experience with a large, growing healthcare organization supporting 100 or more providers and overseeing 10+ team
  members
• Experience with large healthcare billing systems (over 100+ providers) a plus
• At least 3+ years of experience in a healthcare environment or a healthcare claims processing environment is required
• 5+ experience in healthcare industry and 1+ years of supervisory experience/leading a team, in healthcare revenue
  management cycle roles encompassing all phases of the revenue cycle management

We offer a comprehensive benefits package to our eligible employees:

• 401(k) retirement plans with employer Safe Harbor
• Harbor Non-Elective Contributions of 3%


• Discretionary profit-sharing contributions of up to 4%


• Health insurance


• Employer contributions to HSAs and HRAs


• Dental insurance


• Vision insurance


• Flexible spending accounts


• Voluntary life insurance


• Voluntary disability insurance


• Accident insurance


• Hospital indemnity insurance


• Critical illness insurance


• Identity theft insurance


• Legal insurance


• Paid time off


• Discounts at local fitness clubs


• Discounts at AT&T

Additionally, Gastro Health participates in a program called Tickets at Work that provides discounts on concerts, travel, movies, and more.

Gastro Health is the one of the largest gastroenterology multi-specialty groups in the United States, with over 130+ locations throughout the country. Our team is composed of the finest gastroenterologists, pediatric gastroenterologists, colorectal surgeons, and allied health professionals. We are always looking for individuals that share our mission to provide outstanding medical care and an exceptional healthcare experience. We offer a comprehensive benefits package to our eligible employees.

Gastro Health is proud to be an Equal Opportunity Employer. We do not discriminate based on race, color, gender, disability, protected veteran, military status, religion, age, creed, national origin, gender identity, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.

We thank you for your interest in joining our growing Gastro Health team!