Collections Specialist
FLSA Status: Non ExemptClassification: Full-Time Job Overview:The Collections Specialist helps accomplish company goals by providing resolution and service to outstanding receivable accounts. The ideal candidate has the passion and drive, intelligence and integrity, high attention to detail, professionalism and excellent follow skills to increase revenue for our customers.The position requires a thorough knowledge of the healthcare industry and an effective strategy working with insurance carriers to get claims paid. Responsibilities and Duties:
Provides claim resolution for assigned accounts to increase collections and reduce delinquencies
Analyzes Explanation of Benefits and Remittance Advices and ensures claims processed according to members plans
Identifies denial reasons, and follows appeal process to get claims paid
Performs high volume collection phone calls to insurance companies
Meets minimum ‘time on the phone’ requirements
Accesses payer online resources to expedite claims follow up and ensure claims are on file and processing
Follows EOB protocol, retrieve documentation to ensure paid accounts are closed
Accesses billing software to analyze rejection reasons and communicate findings
Communicates billing/coding errors and completes resubmission request
Identifies and reports changes and trends in carrier guidelines and reimbursement patterns
Executes and delivers special projects from management and other duties as assigned
Corresponds with third party rate negotiation companies to expedite claim process
Accesses EMR, retrieves medical records and follows protocol
Adheres to documentation protocol, notates accounts and reports appropriately
Organizes daily and weekly production/action reports in file share
Participates in companywide and departmental meetings
Commits to providing excellent customer service while maintaining the highest degree of professionalism while working in a team environment to meet goals
Understands and complies with all HIPAA rules and regulations
Skills and Competencies:
3-5 years High Volume corporate Collections experience
Knowledge of Billing and Collections procedures
Experience working with online payer resources
Accounts Receivable knowledge/experience a plus
Strong attention to detail, goal oriented
Commitment to excellent customer service
Ability to work efficiently within deadlines
Excellent written and verbal communication abilities
Strong interpersonal skills and ability to work in a team environment
Ability to prioritize and manage multiple responsibilities
Adheres to all policies and procedures as outlined in the Employee Handbook
Proficiency using Microsoft Office products
This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities and working conditions may change as needs evolve.
18.70 To 22 (USD) Hourly
