Medical Collections Specialist

Collections – Insurance

• Collects balances due from commercial and/or governmental insurance and third-party payers ensuring proper reimbursement for all services.

• Identifies denied or underpaid claims and dedicates efforts to ensure proper resolution and timely turnaround within payer guidelines.

• Maintains active, working knowledge of payer claims processing and appeal procedures, provider contracts with insurances and third-party payers, and different payment methodologies.

• Demonstrates knowledge of standard bill forms and filing requirements, explanation of benefits, and online payor portals and resources.

• Identifies and communicates issues and trends impacting account resolution and reimbursement. Summary: Provides medical collection services for TLRA collection units. Utilizes a strong background as a medical collection specialist to successfully resolve accounts placed with TLRA for collection. This involves performing collection activities related to follow-up and account resolution and includes communication with patients, clients, reimbursement vendors, and other external entities while adhering to all client, state, and federal guidelines. Patient and client satisfaction is essential. Associates in the collection units are expected to have knowledge of the overall collection work processes for both active AR and BD inventory.

The Patient Account Specialist Senior is responsible for the accurate and timely billing and collecting of physician services.

Responsibilities: Responsible for performing billing, A/R follow-up and credit balance resolution activities which result in claim payment. Identifies trends and their root cause to improve the effectiveness and efficiency of the physician revenue cycle.

Provide excellent customer service to market personnel, insurance carrier representatives and patients. Document all follow-up efforts in practice management system.

Assists with patient education concerning insurance plan. Follows the Health guidelines related to the Health Insurance Portability and Accountability Act (HIPAA), designed to prevent or detect unauthorized disclosure of Protected Health Information (PHI).

Maintains strict confidentiality. Uses oral and written communication skills to effectively convey ideas in a clear, positive manner that is consistent with the Mission.

Maintains established Health policies, procedures, objectives, quality assurance, safety, environmental and infection control. Implements job responsibilities in a manner that is consistent with the Mission and Code of Ethics and supportive of Health’s cultural diversity objectives.

Supports and adheres to Health Service Guarantee. Performs all other duties as assigned.

Requirements: High school diploma or equivalent; college course work a plus. Ability to operate telephone, computer, copier, fax machine and 10-key calculator by touch. Effective oral and written communication skills Detail oriented. Ability to work independently and as part of a team.

Minimum three years of physician billing experience. Candidate must possess the following: Extensive knowledge of CPT, HCPCS and ICD-9 coding principles in a multi-specialty physician practice. Thorough understanding of government and commercial payer guidelines as well as reimbursement methodologies. Ability to successfully perform all aspects of the physician billing cycle including initial claim submission, payer rejection resolution, denial follow-up, secondary appeal and refund processing. Advanced understanding of medical terminology.

Job Types: Full-time, Contract

Pay: Up to $20.00 per hour

Expected hours: 40 per week

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Life insurance
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Work Location: In person

Salary : $20