What are the responsibilities and job description for the Collections Specialist position at Tranzeal?
Job Description : Revenue Cycle Specialist - Collections
Location : Remote
We are seeking a detail-oriented and experienced Revenue Cycle Specialist to join our team. The ideal candidate will have a strong background in medical collections, insurance verification, authorizations, and revenue cycle management . Experience in dialysis billing and claims processing is a significant plus.
Key Responsibilities :
- Manage the full revenue cycle, including insurance verification, prior authorizations, claims submission, payment posting, and collections .
- Verify patient eligibility and benefits for various insurance plans, including commercial and government payers (Medicare, Medicaid, VA, etc.).
- Obtain prior authorizations for treatments, procedures, and medications as required by insurance carriers.
- Submit and follow up on UB-04 and CMS-1500 claims to ensure timely reimbursement.
- Work denied claims and appeals , ensuring proper documentation and timely resolution.
- Communicate with insurance companies, patients, and healthcare providers to resolve billing issues and discrepancies.
- Monitor and reduce outstanding A / R balances , ensuring collections are maximized.
- Process adjustments, refunds, and write-offs in compliance with payer policies.
- Maintain compliance with HIPAA and payer regulations related to medical billing and collections.
- Collaborate with clinical and administrative teams to streamline revenue cycle processes and improve efficiency.
Qualifications :
