Job Summary:

Under the direction of the Insurance/Billing Supervisor, the Insurance Collections Specialist I is responsible for the timely follow-up and resolution of routine insurance claim denials, unpaid claims, underpayments, and payer inquiries. This role focuses on foundational collections activities, accurate account documentation, and adherence to departmental productivity and quality standards.

This position requires frequent communication with insurance company representatives, dental practices, and patients.

Responsibilities:

- Follow up on unpaid, underpaid, and denied insurance claims.
- Verify claim receipt, processing status, eligibility, and benefits.
- Research and resolve routine claim issues and basic denials.
- Review Explanation of Benefits (EOBs) and apply appropriate collection actions.
- Update patient demographics, coverage information, and account details.
- Ensure timely filing requirements are met.
- Document all account activity accurately and completely.
- Respond to office inquiries regarding claim status and collection activity.
- Maintain productivity and quality metrics.
- Manage assigned work queues and aging accounts.
- Escalate complex claim issues, payer disputes, and contractual concerns to senior team members.

Qualifications:

Education:

- High School Diploma or equivalent required.




- Associate degree in Healthcare Administration, Business, Finance, or related field preferred.
- Revenue Cycle, Medical Billing, Dental Administration, or Insurance coursework preferred.

Experience:

- 1-3 years of healthcare, dental, insurance, customer service, billing, or collections experience preferred.
- Experience working in a production-based environment preferred.
- Previous exposure to insurance claim processing, billing, or account follow-up is beneficial but not required.
- Dental insurance knowledge preferred but not required.

Required Skills:

- Basic understanding of insurance billing claims processing, and collections principles.
- Ability to navigate payer websites, portals, and practice management systems.
- Strong attention to detail and organizational skills.
- Effective verbal and written communication skills.
- Ability to manage assigned work queues and meet production expectations.
- Basic proficiency in Microsoft Office, including Outlook and Excel.
- Ability to learn payer policies, reimbursement methodologies, and collection workflows.
- Strong customer service skills and skilled telephone etiquette.
- Ability to work independently and effectively within a team environment

📌 Insurance collection Specialist (India)
🏢 Smile Brands India
📍 India