Collections Specialist - Denials - Patient Accounts

JOB TITLE: Collections Specialist - Denials DEPT: Patient Accounts LOCATION: Maury Regional Medical Center - Columbia, TN

Full-Time, Monday-Friday several schedules to choose between 6a-6p MAURY REGIONAL HEALTH: At Maury Regional Health, patients are at the heart of everything we do. We're committed to clinical excellence and compassionate care, offering exceptional service. As a top-rated organization, we foster an inclusive, collaborative work environment where innovation and patient care lead the way.

The Collection Specialist is responsible for reviewing and analyzing patient accounts with credit balances to ensure accurate payment posting, reimbursement, and compliance with established payer contracts. This position investigates overpayments and underpayments, determines appropriate patient or insurance liability, and processes refunds, payment transfers, and appeals as necessary. The Collection Specialist collaborates with the Contracting Department and other revenue cycle teams to resolve account discrepancies, maintain accurate financial records, and support timely and compliant reimbursement practices.

DUTIES: Reviews and analyzes patient accounts with credit balances to identify payment discrepancies, determine the source of overpayments, and ensure accurate account resolution. Evaluates insurance claim payments against established payer contracts to verify reimbursement accuracy and identify potential underpayments or overpayments. Documents account findings clearly and accurately, including detailed explanations of payment discrepancies, contractual adjustments, and required corrective actions.

Identifies underpaid claims and initiates appropriate appeals or follow-up actions to recover reimbursement owed according to payer contracts and established procedures. Determines appropriate patient financial responsibility and transfers balances to patient accounts when applicable, ensuring compliance with billing policies and insurance guidelines. Investigates and distinguishes between patient and insurance overpayments and processes appropriate refunds in accordance with organizational policies and regulatory requirements.

Processes payment transfers and account adjustments to ensure funds are accurately applied and financial records reflect correct account balances. Collaborates with the Contracting Department, Revenue Cycle teams, and insurance payers to resolve reimbursement discrepancies, maintain contractual compliance, and identify opportunities for process improvement. JOB

• 3 Years of Related Experience in Medical or Hospital Setting Required
• High School Diploma or Equivalent Preferred WHY MAURY:
• Medical, Dental, Vision, Retirement Plans & PTO
• Educational Assistance, Tuition Reimbursement & Career Advancement Navigation
• Employee Discounts
• Childcare Services
• Adoption Assistance For more information: About Maury Regional Health MISSION, VISION & VALUES: MISSION: Clinical excellence. Compassionate care. Every patient. Every day. VISION: To be the trusted choice for health and wellness in southern Middle Tennessee by delivering a safe, seamless and patient-centered experience. VALUES: W – Wholeness: Wellness-centered care of mind, body & spirit for our patients & health care team. E – Empathy : Understanding the feelings of others as we walk with them on their path to wellness. C – Community: Creating relationships, connections & trust. A – Advocacy: Defending the rights of all to be heard. R – Respect: Treating everyone with dignity & respect. E – Engagement: Actively involving all stakeholders in creating better health outcomes for southern Middle Tennessee. STRATEGIC ANCHORS:
• Quality patient care
• Highly effective teams
• Stewardship of resources
• Innovative culture Maury Regional Health is committed to the principles of Equal Employment Opportunity in all aspects of the employer/employee relationship. Maury Regional Health grants equal employment opportunities to all qualified persons without regard to race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), national origins (including ancestry), genetic information, disability, age, military/national guard/veteran status, sexual orientation, gender identity, or gender expression, or other status protected by state or federal law. Statements made by applicants for employment on this application form will be checked for accuracy. Maury Regional Health campuses are tobacco-free. All tobacco use is prohibited.