Job Summary
CLEAR Recovery Center is seeking an experienced Insurance Collector to join our Revenue Cycle team. The ideal candidate will have experience working with mental health and substance abuse treatment claims and be comfortable handling high-volume insurance follow-up.
This position requires daily communication with insurance companies regarding denied, underpaid, rejected, and outstanding claims. The Insurance Collector will be responsible for overturning denials, submitting appeals, obtaining claim status updates, and coordinating medical records requests to secure payment for services rendered.
Essential Duties and Responsibilities
- Contact insurance companies by phone daily to follow up on outstanding claims.
- Investigate and resolve claim denials and payment discrepancies.
- Prepare and submit first-level and second-level appeals.
- Review Explanation of Benefits (EOBs) and denial reasons.
- Send supporting documentation and medical records to insurance carriers.
- Work with commercial, managed care, Medicare, Medicaid, and behavioral health payers.
- Document all claim activities accurately within the billing system.
- Monitor appeal deadlines and payer requirements.
- Identify trends in denials and recommend corrective actions.
- Collaborate with billing, utilization review, and medical records departments.
Qualifications
- Minimum 2 years of medical insurance collections experience.
- Behavioral Health, Mental Health, or Substance Abuse treatment billing experience preferred.
- Strong knowledge of insurance claim appeals and denial management.
- Experience working with payers such as Blue Shield, Anthem, Magellan, Optum, Aetna, Cigna, TRICARE, and other behavioral health carriers.
- Ability to communicate professionally and confidently over the phone.
- Excellent organization, time management, and follow-up skills.
- Experience with EHR and billing systems preferred (CollaborateMD experience a plus).