Specialist-Collections; Remote

Position: Specialist-Collections (Remote)
Job Requirements

Position Summary

The Collections Specialist is responsible for managing and collecting on accounts receivables for all insurance carrier plan services billed through the hospital/physician billing systems.

Minimum Requirements

Education

* Highs School Diploma or equivalent

Experience

* 3 years medical office or medical billing/collections experience in a hospital or centralized billing setting.

* Must possess knowledge of CPT, HCPCS, and ICD-9/10 codes.

* Must have a good working knowledge with insurance explanation of benefits (EOB) and comprehensive understanding of remittance and remark codes.

* Be familiar with multiple payer requirements for claims processing

* Solid skills with Microsoft office with a focus on Excel and Word.

* Good Communication Skills

License/Registration/Certifications

* N/A

Preferred Requirements

Preferred Education

* N/A

Preferred Experience

* 4+ years' experience in a centralized billing setting.

* Payer Focused collections experience

* Possess an in-depth working knowledge and experience with all types of insurance billing guidelines:
Commercial, Medicare Part A and B, Medicaid, Managed Care plans etc.

* Experience with multiple specialty billing, collections and denials

Preferred License/Registration/Certifications

* N/A

Core Job Responsibilities

* Collections of all outstanding claims by direct payer contact, utilization of payer websites, and through EDI/Claims systems.

* Research and Resolve all payments issues/errors for insurance balances.

* Responsible to complete all error corrections and insurance updates to the facility/professional claim in order to resolve outstanding denial/issue preventing payment.

* Complete claim corrections, coding research requests, as needed to manage outstanding AR.

* Responsible for handling all retro-authorizations for multiple payers.

* Must possess the ability to work in different systems including claims eligibility, online payer claims system, case management as well as all AR management systems.

* Work payer denials and perform all necessary rework for reimbursement of denied services.

* Work closely with multiple departments to obtain necessary information to resolve outstanding AR.

* Update and verify insurance records as needed to correct outstanding accounts.

* Must have working knowledge of registration, payment posting, error correction and other billing functions.

* Manage time and job responsibilities in order to meet monthly goals

* Exhibit professionalism and good customer service skills.

* Other duties as assigned.