KORE1, a nationwide provider of staffing and recruiting solutions, has an immediate opening for a Patient Account Rep / Insurance Collector in Rancho Mirage, CA. This is a contract to hire opportunity and is fully onsite. There is potential for Hybrid/remote work after 1 year of working and doing well in the position.
Shift: M-F from 8:00am - 4:30pm
Job Summary:
This position is responsible for the collection and resolution of outstanding insurance claims for assigned payors. The ideal candidate will have strong insurance follow-up experience and a problem-solving mindset to ensure accurate and timely reimbursement.
Key Responsibilities:
• Monitor and manage insurance accounts receivable for assigned payors, ensuring timely follow-up and resolution.
• Contact insurance companies via phone or portal to resolve claim denials, underpayments, and delays in reimbursement.
• Review Explanation of Benefits (EOBs), Electronic Remittance Advice (ERAs), and claim status reports to determine next steps.
• File appeals or corrected claims as necessary, following up within timely filing limits.
• Identify recurring claim issues or denial trends and escalate to supervisor as needed.
• Collaborate with internal departments such as billing, coding, and front desk staff to obtain needed documentation for claims.
• Accurately document all actions, communications, and claim statuses in the billing system.
• Stay up to date with insurance guidelines, policies, and payer-specific rules.
• Ensure all activities are compliant with HIPAA and organizational privacy standards.
• Meet productivity, quality, and aging goals set by leadership.
Qualifications:
• High School Diploma or equivalent required; Associate's degree preferred.
• 2+ years of experience in medical billing, insurance follow-up, or patient account services.
• Strong understanding of insurance claim processing, including Medicare, Medi-Cal, and major commercial payors.
• Familiarity with CPT, ICD-10, HCPCS coding, and common orthopedic procedures preferred.
• Proficient with billing software systems and Microsoft Excel
• Strong communication, organizational, and problem-solving skills.
• Ability to work independently and maintain high accuracy in a fast-paced setting
Preferred Experience:
• Prior experience in orthopedic billing or with a specialty medical group
• Knowledge of EHR/PM systems (e.g., NextGen, Epic, or similar)
• Experience working in a California-based healthcare environment