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Collections Specialist - Healthcare

Summit BHC
Franklin, TN Full Time
POSTED ON 1/22/2025
AVAILABLE BEFORE 4/22/2025

Collections Specialist - Healthcare | Summit Healthcare Mgmt | Franklin, Tennessee

About the Job :

The Collections Specialist is responsible for providing AR management to include insurance account follow up in a timely and effective manner using healthcare business software applications as a part of the Centralized Business Office team. Responsibilities include recording receivable activities, identifying and resolving account discrepancies to ensure timely reimbursement.

Roles and Responsibilities :

  • Pursues payment from third party payers as well as patients when needed.
  • Ensure assigned follow up que is in compliance with manager expectations.
  • Prepare adjustment forms and refund requests for management approval.
  • Reporting payer and denial trends to upper management through continued communication with local UR teams.
  • Ensure denials are captured on the appropriate log in a timely manner.
  • Research disputed or slow reimbursed claims.
  • Documents collection follow-up efforts in the electronic patient accounting system.
  • Initiates contact with third-party payers and tracks payment progress.
  • Ensures accuracy of account balances.
  • Generates AR reports as required by management.
  • Assists with A / R Month End close process.

Education / Experience / Skill Requirements :

  • High school diploma or GED required.
  • At least two (2) years' experience in billing and collections, preferably in a behavioral healthcare setting, with a working knowledge of computers and business software applications required.
  • Working knowledge of Medicare / Medicaid guidelines and Institutional (UB04) Billing Requirements
  • Knowledge of UB04 forms, HCFA 1500 forms, CPT-4 and ICD10CM coding
  • Two years of experience in Provider Enrollment / Credentialing with Medicare, CAQH, and other major insurance carriers.
  • Why Summit Healthcare Mgmt?Summit Healthcare Mgmt offers a comprehensive benefit plan and a competitive salary commensurate with experience and qualifications. Qualified candidates should apply by submitting a resume. Summit Healthcare Mgmt is an EOE.

    Veterans and military spouses are highly encouraged to apply. Summit BHC is dedicated to serving Veterans with specialized programming at our treatment centers across the country. We recognize and value the unique strengths of the military community in supporting our mission to serve those who have served.

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