Medical Collections Specialist

Praesum Healthcare

Founded in 2003, Praesum Healthcare provides administrative services for healthcare providers in key geographical locations throughout the Northeast, mid-Atlantic, and Southeast regions. Praesum is an established leader in the healthcare industry. With a, growth-focused business model, strong finances, and expert management team, Praesum will continue to grow in the years to come. Praesum currently provides services to behavioral health facilities providing all levels of care from inpatient psychiatric and substance abuse detoxification, through SUD and mental health outpatient clinics, and several diagnostic reference laboratories.

This position is responsible for performing payment follow-up and collection activities on patient accounts as assigned. The Medical Collections Specialist will have to call insurance carriers directly and attempt to collect on the unpaid claims. The successful candidate has excellent written and verbal communication skills while being professional yet assertive. Highly effective organizational skills are required for accuracy and timely gathering of data.

This fast-paced position requires a high attention to detail, prior knowledge of insurance claim collections and/or filing is a plus.

• Review and audit medical records for accuracy in billing, coding and insurance requirements
• Organize and manage patients' health information data
• Prepare daily charges and claims to be submitted electronically to clearing house and insurance carriers
• Accounts Receivable follow up with insurance carriers
• Claim denial management with electronic clearing house
• Utilize 3 different code sets: CPT, HCPCS, and ICD-10 for appropriate billing to insurance carriers
• Release information to persons and agencies according to state and federal regulations
• Possess the ability to critically analyze documentation, assigning proper codes.
• Knowledge of Insurance Explanation of Benefits (EOB)
• Thorough understanding of the revenue cycle process, from patient access through patient financial services procedures and policies
• Knowledge of CMS rules and regulations related to billing, collections and compliance

• High School Diploma or GED equivalent
• AA Degree or Vocational training preferred in a related field
• A minimum of 2-3 years of experience in a medical collection role—communication with both patients and insurance companies
• Individual must be computer literate with proficiency in Microsoft Office applications.
• Customer Service skills/experience 1-2 years
• Analytical skills

• Full Time
• Monday - Friday
• 8:00AM - 5:00PM

• Hourly rate competitive with experience

• Insurance:
  Medical, Dental, Vision, and STD options
• Medical FSA and Dependent Care Account
• 401k with company match up to 5%
• Accrued Paid Time Off (PTO)
• Education reimbursement
• Career Advancement Opportunities

*** This job does NOT sponsor visa's and we are unable to consider out of country applicants ***

If you are interested in this opportunity or know someone that you respect who would be a good fit for this position, please email:
Clay –  Healthcare Recruiter
James –  Healthcare Recruiter