Position Overview:
At OrthoArkansas, our Insurance Collectors play a key role in ensuring timely and accurate reimbursement of claims—directly contributing to the clinic’s financial health and supporting providers in maximizing revenue. In this position, you will process claims, resolve denials, assist with appeals, and collaborate with internal teams and insurance carriers to resolve outstanding issues. You'll be part of a dynamic, supportive team committed to driving efficient reimbursement and a seamless patient-provider experience.

Key Responsibilities:

1. Claims Management:

   • Manage payer-specific claim buckets, processing approximately 60 claims daily.

   • Investigate and follow up on unpaid claims to ensure timely reimbursement.

   • Draft and submit appeal letters; communicate with insurance carriers regarding denied claims.

   • Identify and correct errors such as duplicate charges, incorrect coding, and registration discrepancies.

2. Denial and Error Resolution:

   • Resolve soft denials and insurance refunds through thorough claim follow-up.

   • Use payer platforms (e.g., AHIN, Medicaid, CMS) to identify and resolve claim discrepancies.

   • Collaborate with the Reimbursements Manager before writing off any claim balance.

   • Research payer policies to ensure compliance and accurate claims submission.

3. Documentation and Communication:

   • Maintain accurate documentation in the billing system, tracking claim activity and outcomes.

   • Respond to inquiries from OrthoArkansas staff about account or claim status.

   • Update and manage physician dashboards to reflect current reimbursement progress.

4. Insurance Relations and Meetings:

   • Communicate with insurance companies via mail, phone, and online portals to resolve claims.

   • Attend insurance meetings as needed to stay informed on payer policies and coverage changes.

5. Evolving Responsibilities:

   • Take ownership of escalated and long-outstanding claims, including high-priority or high-dollar accounts.

   • Address denials tied to coding, medical necessity, or payer policy.

   • Partner with coding specialists or providers to resolve complex claim issues.

   • Review and interpret insurance contracts and payer-specific reimbursement guidelines.

6. Appeals and High-Priority Claims:

   • Assist with claim appeals and manage complex, high-volume denials to secure reimbursement.

7. Mentorship and Collaboration:

   • Train and support junior follow-up specialists.

   • Partner with departments including coding and finance to address systemic issues and streamline claim resolution processes.

8. Process Improvement:

   • Identify trends in denials and contribute to process improvement initiatives.

   • Report on denial resolution outcomes and suggest strategies for reducing rejections.

9. Additional Duties:

   • Perform other related duties as required to support overall revenue cycle operations.

Qualifications:

• Education & Experience:

  • High school diploma or GED required.

  • 0 to 6 months of related experience or equivalent combination of education and training.

  • Orthopedic billing or coding experience is preferred, but not required.

• Skills & Abilities:

  • Highly organized with excellent attention to detail.

  • Strong verbal and written communication skills.

  • Effective problem-solving and decision-making abilities.

  • Ability to manage multiple tasks in a fast-paced environment.

  • Commitment to patient confidentiality and HIPAA compliance.

• Preferred Skills (Not Required):

  • Proficiency in CPT and ICD-10 coding.

  • Familiarity with insurance reimbursement and billing practices.

  • Analytical skills to identify denial trends.

  • Experience in billing software and dashboard reporting.

  • Leadership or mentoring experience.

Software Skills:

• Advanced: Alphanumeric data entry.

• Intermediate: 10-Key, database management, spreadsheet, word processing.

• Basic: Accounting and contact management.

Perks of This Position:

• Impactful & Rewarding Work – Drive successful claims resolution and help support OrthoArkansas' financial operations.

• Attractive Compensation & Comprehensive Benefits – Enjoy a competitive package including medical coverage, life insurance, 401(k) with employer profit-sharing contributions, paid time off, and paid holidays.

• Culture of Excellence – Be part of a values-driven team focused on kindness, integrity, conscientiousness, and lifelong learning.

• Professional Growth & Development – Access continuing education and development opportunities in insurance billing and healthcare reimbursement.

• Collaborative & Supportive Team – Join a high-performing environment where knowledge-sharing and team success are encouraged.

Additional Details:

• Performance Expectations: Ensure timely claim resolution, collaborate across departments, and maintain high standards in accuracy and communication.

• Professional Development: Stay current with insurance policy changes and continue to grow your skills in denial management and revenue optimization.

Join OrthoArkansas as an Insurance Collector and help shape a smooth, efficient, and impactful billing and reimbursement experience. This is your opportunity to contribute to a high-functioning team in a fast-paced and rewarding healthcare setting.