Collection Specialist

Job Title: Collection Specialist

Reports To: Accounting Lead

FLSA: Exempt

Department: Accounting

Summary of Job Description:

Under general direction the Collection Specialist will plan, organize, direct, and coordinate the collections and accounts receivables functions for Psynergy Programs and its related entities. The collections specialist will play a critical role in the interaction with the counties, state, and federal personnel. She will manage a designated portfolio of inpatient and outpatient claims, ensuring effective and efficient collection efforts. Responsibilities and duties include the following but are not limited to the following:

· Conducting regular account reviews to identify outstanding balances.

· Initiating and maintaining communication with third-party payers to resolve reimbursement discrepancies.

· Diligently following up on claims to ensure timely resolution.

· Communicate with insurance providers, patients, and internal departments to gather necessary information and resolve payment issues.

· Computer literacy, including ability to use word processing, spreadsheet and database applications including excel.

· General knowledge of facility operations.

· Make independent decisions and use good judgments in applying policies, rules, and regulations on collections and accounts receivables.

· Plan work and carry projects through to completion with minimum supervision.

· Edit, spell correctly and use proper English and make arithmetical computations.

· Communicate effectively orally and in writing to the extent of writing procedures and analytical reports and making oral presentations before large and small groups.

· Understand and accurately follow brief oral and written instructions.

· Establish and maintain effective and professional working relationships with internal and external staff/personnel.

Accounts Receivable:

· Maintain up to date and accurate data related to accounts receivable reports within QuickBooks.

· Liaise via active collection activities (such as phone & email outreach) with related Payees to arrange payment of overdue room and board invoices.

· Maintain accurate data within QuickBooks related to admits, discharge and transfer of clients.

· Monthly billing of board and care and private clients, including invoice generation.

· Apply all payments and make company deposits daily (including checks).

Qualifications:

We are seeking a self-directed, detail-oriented individual with:

· High school diploma or GED; Minimum of 5 years of relevant experience, including at least 1 year in collections investigation

· Experience in commercial and managed care collections, highly desired

· Ability to interpret payer contracts and process contractual adjustments

· In-depth knowledge of UB04 requirements and medical billing processes

· Strong analytical skills and proven proficiency in Excel and spreadsheets

· Understanding of collection techniques and laws, including AB1455, the Knox-Keene Act, Health & Safety Codes, etc., Familiarity with medical terminology, CPT codes, HCPCS codes, health networks, IPAs, HMOs, PPOs, PCPs, and contract affiliations

· Excellent verbal and written communication skills

· Proficiency in Microsoft Office, especially Excel and Word

· Exceptional organizational skills, with the ability to meet deadlines, work independently or as part of a team, and prioritize tasks effectively The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Language Ability:

Ability to read and interpret documents such as safety rules, operating and maintenance instructions and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of an organization.

Office Behavioral Expectation:

Ability to conduct themselves professionally, fostering a collaborative and inclusive environment, prioritizing teamwork, open communication, and adherence to ethical standards, while actively contributing to the achievement of team objectives and embracing the organization's values of integrity, accountability, and continuous improvement.

Math Ability:

Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percent and to draw and interpret bar graphs.

Reasoning Ability:

Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized and emergency situations.

Computer Skills:

To perform this job successfully, an individual should have knowledge of Microsoft Word; Microsoft Excel; inventory software; internet software; order processing systems; and database software.

Certificates and Licenses:

Valid Driver’s License - Must meet insurance underwriting requirements.

Work Environment:

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is occasionally exposed to toxic or caustic chemicals and outdoor weather conditions. The noise level in the work environment is usually moderate.

Special Requirements:

Must be able to meet and receive a criminal records clearance as required by Title XXII, licensing regulations. This includes FBI and DOJ clearance. A health screening, by or under the direction of a physician must have been performed not more than one year prior to employment or within seven (7) days after employment. Health screening must include TB clearance not more than one year prior to employment or within seven (7) days after employment. Must have a “valid” standard first aid card from an accredited institution. Must be physically able to assist clients and/or staff in the evacuation of program facility in emergency situations. Must be able to administer first aid in an emergency.

Physical Requirements of Position:

The following are required in day-to-day performance of the duties of this position: Walking, Sitting, Pinching and Finger Flexion, and Visual/Auditory Acuity are required constantly (over 2/3 of the workday); Lifting, Carrying, Pushing, Pulling, Bending, Stooping, Crouching, Kneeling and Twisting are required occasionally (under 1/3 of the workday). Balancing, Climbing and Crawling are generally not required.