Collection Specialist

1 week ago

Ortigas Metro Manila, Philippines Eastvantage Business Solutions Inc. Full time

As a Collections Specialist, you will serve as a bridge between the billing department and third-party payers to resolve overdue claims and collect payments. In this role, you will be responsible for ensuring accurate billing and efficient collections processes within our healthcare organization.

Core Responsibilities:


• Monitor accounts to identify overdue payments and correct errors in previously submitted

claims to ensure full payment


• Clearly communicate with team members, third-party payers, and customers regarding identified claims errors via phone and email


• Identify, analyze, and research trends in claims rejections and partial payments to create resolutions.


• Prioritize activities to work denials and partial payments in a timely manner to avoid timely filing limitations.


• Leverage reporting tools for comprehensive data analysis, creating targeted action plans to resolve billing issues.


• Utilize coding systems (CPT, ICD-10) to guarantee meticulous billing and collections


• Process and reprocess medical claims in accordance with payer regulations, protocols, medical authorizations, and departmental guidelines.

Experience and Skills:


• Minimum 2 years of experience in medical billing and collections.


• Experience working with third-party payers, such as VA, Medicaid, Medicare Advantage, and Worker's Compensation


• Experience with revenue cycle management


• Experience working with UB04 and HCFA 1500 forms


• Familiarity with Electronic Medical Record (EMR) systems


• Knowledge of health care collections procedure codes and techniques


• Proficiency in using billing software (Clearinghouse) and electronic health records (EHR)


• Proficiency in reading and interpreting ERAs and EOB for all payers


• In-depth knowledge of healthcare billing codes (CPT, ICD-10)


• Proven success in reducing accounts receivable and improving collections


• In-depth knowledge of HIPAA compliance


• Excellent follow-up, time management, and communication skills required


• Familiarity with PowerBI preferred


• Proficiency in MS Office Suite (Outlook, Word, Excel) required.

Education and Qualifications:


• Associate degree required in Healthcare Administration, Business, or a related field (bachelor's degree preferred)


• Equivalent combination of education and experience will be considered.

phhiring #healthcare #medicalbilling #collections #CPT #ICD10 #HIPAAcompliance

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