Collection Specialist

Key Responsibilities

• Manage assigned accounts and ensure the timeliness and accuracy of billing, collections, and payment activity
• After an account is billed, the account becomes the Collector’s responsibility.
• Verification that a claim is on file
• Follow up with the payer due to lack of payment
• Investigation of denials
• Cordination with the billers to address billing issues
• Cordination with the funding consultants to address documentation questions
• Preparation of correspondence, such as appeals, to fight for the payment of accounts, request different denial codes, etc.
• Review of posted payments for accuracy and investigate differences
• Document in the system all verbal and written communication relative to collection actions and expected outcomes of overdue accounts.
• Follow up every 30 days with insurance companies, clients, SPLs, and vendors to ensure the payment of accounts
• Alert the Manager of Collections of potential payment issues
• Recommend adjustments/write-offs to the Manager of Collections and receive approval prior to reconciling accounts
• Investigate refund requests related to accounts and complete refund paperwork for accounts that need to be refunded
• Maintain productivity and cash targets as set forth by management
• Stay abreast of state, federal, and third-party funding regulations for assigned accounts ensuring billing and payment practices comply with third party payer requirements
• Perform various other tasks as assigned

Minimum Qualifications

• High School Diploma
• 2 or more years of computer, accounting, collections, and high-volume medical billing and/or insurance claims processing experience
• Knowledge of payment posting process in regard to contractual adjustments and refunds preferred
• Knowledge of medical insurance claims procedures and documentation preferred
• Communication Skills: Strong customer service and interpersonal skills, Oral and written communication skills, Teaming skills
• Technical Skills: Proficient in M.S. Office Word, Excel, and Outlook, Able to research claim information via the internet, Basic data and word processing skills
• Other: Apply independent judgment and manage confidential information, Ability to gather data and summarize information, Time management and good organizational skills, Excellent problem-solving skills, Record management

Work Environment

• Ability to work at a desk for prolonged periods of time
• Ability to work with interruptions in a fast-paced environment