Self Pay Collection/Insurance Verification Specialist

This is a fully remote position, open to applicants in Texas.

📋 Description

• Reach out to patients concerning self-pay balances and negotiate payment plans.

• Pursue unpaid and overdue accounts while compiling a monthly list for third-party collections.

• Address patient inquiries regarding accounts, outstanding balances, billing statements, payment options, and financial aid.

• Inform patients about co-pays, deductibles, account balances, and their financial obligations.

• Accurately apply patient payments to the respective accounts.

• Record collection efforts, payment arrangements, communications with patients, insurance information, authorization numbers, and verification outcomes.

• Contact insurance providers to clarify benefits, settle discrepancies, and confirm coverage and eligibility.

• Verify co-pays, deductibles, and out-of-pocket expenses related to procedures and treatments.

• Secure prior authorizations, precertification numbers, and referrals as necessary.

• Identify coverage issues prior to service to minimize claim denials.

• Collaborate with billing, coding, scheduling, and clinical teams to ensure services are accurate, compliant, and properly authorized.

• Confirm coverage for commercial, workers’ compensation, accident, and state programs.

• Assess patient responsibility and eligibility for coverage.

• Monitor aged accounts and investigate discrepancies in self-pay, billing errors, and misapplied payments.

• Analyze payer contracts to determine patient responsibility.

• Keep current insurance contracts and payment schedules for the facility.

• Offer financial counseling regarding payment options and assistance programs.

• Adhere to the Self-Pay Process Policy and Procedure.

⛳️ Requirements

• High school diploma or GED is required.

• At least 2 years of experience in healthcare revenue cycle, medical, ASC, or a related field.

• Familiarity with patient accounting systems such as Advantx, Vision, HST, SIS Complete, or MoD Med is advantageous.

• Understanding of payer contracts, EOBs, and HIPAA regulations.

• Comprehensive knowledge of the complete revenue cycle.

• Familiarity with Medicare, Medicaid, PPO, HMO, deductibles, co-pays, and coinsurance.

• Capability to identify discrepancies and swiftly resolve coverage issues.

• Strong organizational and time management abilities.

• Keen attention to detail for identifying and resolving account discrepancies.

• Excellent communication and customer service proficiency.

• Competence with insurance portals, EHRs, payer contracts, and billing software.

• Understanding of HIPAA and relevant state and federal regulations regarding collections and patient confidentiality.

• Access to reliable internet and a distraction-free workspace.

• Availability to work standard hours from 8 a.m. to 5 p.m. CST.

🏝️ Benefits

• Medical, dental, and vision insurance.

• 401(k) matching after one year of employment.

• Vacation, sick leave, and paid holidays.

• Opportunities for training and career advancement.

• Fully remote work from home.

• Secure internet and a direct phone line.