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This role is responsible for ensuring the timely and accurate resolution of accounts receivable through effective claims processing, cash collections, and appropriate write-offs. The ideal candidate will demonstrate a strong understanding of medical billing, insurance verification, and payment posting. They will be capable of independently investigating and correcting claim denials, resubmitting claims, and processing appeals. This position requires a high level of attention to detail, excellent organizational skills, and the ability to collaborate across departments.
Job Responsibility:
Review, correct, and process claims for all payers, both electronically and manually
Investigate and resolve claim denials, making corrections as needed
Apply accurate contractual adjustments to resolve outstanding balances
Respond to billing inquiries from patients and insurance representatives professionally and promptly
Reconcile patient collections and deposits
Identify and report denial trends
propose solutions to reduce future denials
Process refund requests and ensure compliance with payer guidelines
Maintain accurate and detailed documentation within patient account
Process appeals, including online and paper submissions
Submit outstanding accounts receivable daily per company protocol
Work claims exceptions (ERL rejections) through the clearinghouse each day
Interpret Accounts Receivable and apply correct adjustments in accordance with accounting principles
Provide outstanding service to patients, internal teams, and third-party payers
Review and resolve aged held billing issues (e.g., sales orders not auto-confirming due to errors)
Collaborate effectively across departments to gather and share necessary data
Adapt to changes in a fast-paced, evolving work environment
Position may require occasional cross-departmental support, including insurance verification and payment posting
Comply with all HIPAA, legal, and ethical standards, including Advanced Code of Ethics
Coloplast employees are required to conduct business to the highest ethical and professional standards
comply with applicable laws and regulations, the Advamed Code of Ethics on Interactions with Healthcare Professionals, and company policies
Occasionally, employees currently recognized as high performers through recent performance evaluations, or employees with current demonstrated productivity leadership compared to other employees on existing metrics may be asked to engage in overtime
Comfort Medical employees are required to conduct business to the highest ethical and professional standards
comply with applicable laws and regulations, the Advamed Code of Ethics on Interactions with Healthcare Professionals, and company policies
Other job duties as assigned
Requirements:
High school diploma or equivalent
Minimum of 3 years’ experience in collections
At least 1 year of experience in healthcare billing, insurance verification, or government medical programs (DME experience preferred)
Strong knowledge of medical terminology and healthcare reimbursement processes
Proficiency in reading and interpreting claim rejections and EOBs (Explanation of Benefits)
Solid negotiation skills and proven track record in collections
Nice to have:
Experience in DME (Durable Medical Equipment) billing and collections
Bilingual in Spanish and English
Brightree Software
What we offer:
Comprehensive medical, dental, and vision insurance plans
Access to company sponsored wellness programs and mental health resources
Paid leave of absence for qualifying events
Generous paid parental leave for both birthing and non-birthing parents
Competitive 401(k) plan with company match that vest immediately
Financial planning services
Corporate discount programs for goods and services
Generous paid time off
Flexible work hours
Flexible work arrangement options
Opportunities for continuous learning and career advancement through training programs, mentorship, and tuition reimbursement
Recognition programs to celebrate achievements and contributions, including peer recognition, bonuses, awards, and special events
A supportive work environment
Participate in team-building activities, volunteer opportunities, and company-sponsored events