Medical Collections Specialist, Full-Time (Hybrid)

General Summary Of Duties The primary responsibility of the Medical Collection Specialist is to ensure effective collection of all patient accounts. This is a hybrid/remote position requiring internet speed of 5MB upload and 5MB download. Requirements High School Diploma3 to 5 years previous experience in office billing and collections environment (CBO)High degree of attention to detail and accuracyAbility to prioritize work assigned independently and multi-taskKnowledge of insurance, billing terms, CPT/ICD10, coding and DRGKnowledge of modifiers usage and CCI editsStrong medical insurance backgroundWorking knowledge of MS Office applications which includes Outlook, Word, Excel, and Power PointCritical thinking skillsSpine/Orthopedic surgery experience preferredEPIC experience preferredMinimum of three years’ experience in medical collectionsHospital Billing/Collections preferred Essential Functions Perform extensive insurance claim follow-ups for insurance denials, appeals, and perform next steps a mustAbility to utilize multiple patients accounting and billing applications including but not limited to claims clearing house systems, payer websites,Ability to interact with the payer representatives, HIM, Insurance Verification and Access Service departmentsParticipates in group meetings and /or various committeesAbility to effectively present information regarding denial trends, and present to managementAbility to read, understand, interpret and resolve payer denials and EOB'sUnderstanding of copays, coinsurance, deductibles, and denial codesEnsure denial reviews, claim follow-ups are conducted in a timely manner in accordance with payer timely filing limitsCorrect claims and file appeals with supporting documents to insurance companies, by phone, electronically or mailAbility to work receivables to investigate and resolve denials and partial paymentsAbility to calculate reimbursement per payer contractMaintains a positive attitude toward their position and responsibilities Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essentialWhile performing the duties of this job the employee is frequently required to sit, converse, and listen; use hands to touch, handle, or feel objects, tools, or controls; and to reach with hands and arms. Specific vision abilities required by this job include close vision and the ability to adjustThe employee must be able to lift and/or carry over 20 pounds on a regular basis and be able to push/pull over 25 pounds on a regularThe employee must be able to stand and/or walk at least five hours per Work Environment The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential