Specialist-Collections

Job Requirements

Position Summary

The Collections Specialist is responsible for managing and collecting on accounts receivables for all insurance carrier plan services billed through the hospital/physician billing systems.

Minimum Requirements

Education

• Highs School Diploma or equivalent

Experience

• 3 years medical office or medical billing/collections experience in a hospital or centralized billing setting.
• Must possess knowledge of CPT, HCPCS, and ICD-9/10 codes.
• Must have a good working knowledge with insurance explanation of benefits (EOB) and comprehensive understanding of remittance and remark codes.
• Be familiar with multiple payer requirements for claims processing
• Solid skills with Microsoft office with a focus on Excel and Word.
• Good Communication Skills

License/Registration/Certifications

• N/A

Preferred Requirements

Preferred Education

• N/A

Preferred Experience

• 4+ years' experience in a centralized billing setting.
• Payer Focused collections experience
• Possess an in-depth working knowledge and experience with all types of insurance billing guidelines: Commercial, Medicare Part A and B, Medicaid, Managed Care plans etc.
• Experience with multiple specialty billing, collections and denials

Preferred License/Registration/Certifications

• N/A

Core Job Responsibilities

• Collections of all outstanding claims by direct payer contact, utilization of payer websites, and through EDI/Claims systems.
• Research and Resolve all payments issues/errors for insurance balances.
• Responsible to complete all error corrections and insurance updates to the facility/professional claim in order to resolve outstanding denial/issue preventing payment.
• Complete claim corrections, coding research requests, as needed to manage outstanding AR.
• Responsible for handling all retro-authorizations for multiple payers.
• Must possess the ability to work in different systems including claims eligibility, online payer claims system, case management as well as all AR management systems.
• Work payer denials and perform all necessary rework for reimbursement of denied services.
• Work closely with multiple departments to obtain necessary information to resolve outstanding AR.
• Update and verify insurance records as needed to correct outstanding accounts.
• Must have working knowledge of registration, payment posting, error correction and other billing functions.
• Manage time and job responsibilities in order to meet monthly goals
• Exhibit professionalism and good customer service skills.
• Other duties as assigned.