What are the responsibilities and job description for the Collection Specialist position at VNA of Texas?
The Collection Specialist is responsible for managing and resolving outstanding account balances from healthcare, hospice, or commercial insurance payers. The role requires expertise in navigating insurance policies, claims processing, and payment procedures. The ideal candidate will demonstrate professionalism, excellent communication skills, and a proactive approach to securing timely reimbursements while ensuring compliance with company policies and industry regulations.
Responsibilities include:
- Accounts Receivable Management:
- Review and manage outstanding balances for healthcare, hospice, or commercial insurance accounts.
- Monitor accounts for timely payments, claim denials, and discrepancies.
- Claims Processing:
- Submit, follow up on, and appeal insurance claims to ensure proper reimbursement.
- Investigate and resolve claim denials, underpayments, and delays.
- Customer and Payer Communication:
- Communicate with insurance companies, patients, regarding denials and appeals.
- Provide clear and professional explanations of account balances and insurance coverage to patients and families, as necessary.
- Documentation and Compliance:
- Maintain accurate records of account activity, payer communications, and resolutions.
- Ensure compliance with HIPAA and other relevant regulations.
- Reporting:
- Generate monthly aging reports on collection activities, outstanding balances, and resolution.
- Provide insights and recommendations for process improvements.
- Collaboration:
- Work closely with the billing department and Intake teams to address and resolve account issues.
- Partner with management to identify and implement best practices for efficient collections.
Qualifications
- Education:
- High school diploma or GED required; associate or bachelor’s degree in business, Accounting, or a related field is preferred.
- Experience:
- 2 years of experience in collections, billing, or accounts receivable in a healthcare, hospice, or commercial insurance environment.
- Strong understanding of insurance claim processing, including EOBs, denials, and appeals.
- Skills:
- Proficiency in medical billing software and MS Office (Word, Excel, Outlook).
- Excellent verbal and written communication skills.
- Strong analytical and problem-solving abilities.
- Attention to detail and ability to work independently.
- Other Requirements:
- Knowledge of healthcare regulations, including HIPAA.
- Familiarity with ICD-10, CPT codes, and revenue cycle management is a plus.
- Medicaid Hospice, TMHP and Availity experience is a plus.