Collections Specialist

About the role

This multi-task position covers all main functions of the business office, including contacting commercial and managed Medicaid payors to collect on unpaid claims, submitting account corrections and adjustments, denial management, payment variance management, and appeal submissions when required. You will work with management to identify trends and address root causes of issues in the A/R, collaborating with other team members and departments to ensure timely account resolution.

Responsibilities

• Contact commercial and managed Medicaid payors to collect on unpaid claims in a timely and accurate manner
• Submit account corrections and adjustments
• Manage denials and payment variances
• Submit appeals when required
• Identify trends and address root causes of issues in the A/R
• Collaborate with other team members and departments to resolve accounts efficiently
• Document accounts accurately and maintain clear communication

Requirements

• High school graduate or equivalent (preferred)
• Minimum of two (2) years of collection experience in a healthcare setting or equivalent combination of education, training, or business office experience
• Hospital experience highly preferred
• Working knowledge of insurance rules and regulations
• Basic familiarity with MS Excel
• Excellent communication skills and professional demeanor
• Detail-oriented with strong time management skills to handle multiple priorities in a fast-paced environment
• May require occasional overtime, flexible hours, and weekend/holiday work

Skills

• Understanding of third-party payor rules and regulations
• Ability to read UB04 forms and EOBs
• Knowledge of account resolution in accordance with federal and state regulations
• Ability to verify benefits via online portal or phone
• Understanding of payor contracts and ability to verify correct payments
• Ability to identify next steps for denied or rejected claims
• Strong organizational, communication, and prioritization skills

Benefits

• On-site cafeteria
• Employee engagement events
• Employee assistance program
• Employee recognition program
• Free parking
• Career and training development opportunities
• Dynamic and inclusive work environment
• Engaged management team dedicated to your success
• Guiding mission and values anchoring collective purpose

Benefits are subject to change at the discretion of Ridgeview Institute Smyrna.

Pay

This is a full-time, non-exempt role with an expected compensation range of $23.00 to $26.00 per hour, based on experience and skill level.