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Insurance Collections Specialist - Full-Time In Irvine, CA

Smile Brands Inc.

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Overview

Smile Brands, a three-time Glassdoor Best Place to Work, is seeking an Insurance Collections Specialist to join our team. We are seeking a detail-oriented individual with experience in claims appeals and reviewing EOBs. The ideal candidate will feel comfortable in a fast-paced environment.

Responsibilities:

  • Calling insurance carriers or any other practical research resources to verify if a claim has been received and what the outcome paid and/or denial reason is
  • Contacting and following up with insurance company representatives
  • Updating all patient accounts to correct inaccurate information i.e. demographics, eligibility dates, termination dates and contract allowance and/or maximum
  • Managing the workflow of assigned accounts and meeting deadlines for filing to obtain maximum reimbursements. Monitoring collections activity for timely payment from all revenue sources
  • Understanding and staying informed of changes with procedures, billing guidelines and laws for specific insurance carriers or payers
  • Following up on any overdue accounts and researching accounts to determine why the balance remains unpaid
  • Auditing insurance claims to identify and provide required attachments and auditing attachments for completeness and suitability
  • Working zero paid or partial paid Explanation of Benefit (EOB) and take action to appeal or properly adjudicate claims
  • Ensuring claim submissions for secondary coverage is within timely filing limits
  • Ensuring responses to claim inquiries and tracing is within timely filing limits
  • Conducting full patient account audits to determine appropriate action
  • Ensuring all dental billing/collection letters are prepared and mailed according to the set schedule

Responsibilities

What we want from you:

  • 2 years of experience in a similar role calling on collections, reviewing claims and appeals
  • A G3 attitude – Greeting, Guiding & Gratitude – in verbal and written communications with internal and external clients

What We’ll Offer You

  • Unparalleled support to grow your career
  • Remote Opportunities
  • A culture that celebrates success and diversity
  • Benefits and perks for you, your family and even your pets!
  • Medical, Dental, Vision, 401K and paid time off for full-time positions


Smile Brands Inc. and all relevant Affiliates are Equal Opportunity Employers. We are proud to celebrate diversity and provide an inclusive workplace for all employees.

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