Collection Specialist
2 weeks ago
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.
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