The Insurance Collections Specialist is an essential part of the TOA Central Business Office, our operation that focuses on revenue cycle excellence. As an Insurance Collections Specialist, you will use your analytical, financial, and customer service skills to ensure that the accounts of our TOA patients are accurate and reconciled in a timely fashion. Essentially, you’ll be working to make sure that TOA claims filed to an insurance payer are processed accurately and timely. This position reports to our Assistant Director of Revenue Cycle, and is located at our Central Business Office location.
The Insurance Collections Specialist focuses on reviewing patient accounts, promptly identifying any errors or other issues in claims processing, effectively following up on any unpaid balances, and expeditiously bringing any remaining balance to resolution.
Identifies denial trends and provides potential solutions while analyzing patient accounts utilizing our EPM system – Nextgen to determine appropriate action.
Communicates with insurance payer representatives, patients, and TOA staff to ensure timely and accurate resolution of account transactions. This would include Commercial plans, Medicare/Medicare HMO plans, Medicaid/Medicaid HMO plans and BCBSTN.
Prioritizes assigned accounts to maximize aged accounts receivable resolution
Reviews explanation of benefit (EOB) documentation and notate accounts on collection activity to perform account resolution
At TOA, our patients deserve the best care, and that extends beyond the clinic to include how we handle our business administration activities.