Full employer posting
Under the direction of the Business Office Manager, the Collections Specialist is responsible for follow up on delinquent surgery center claims), working an expected number of claims per day. Majority of claims will have been submitted to various insurance carriers electronically. Knowledge of how to interpret a managed care contract, Medicare and Medicaid and Workers Compensation claims is a must.
You will be given tools to calculate allowable and required to determine appropriateness of reimbursement and appeal claims as necessary. Extensive contact with insurance carriers of all types, as well as communication with patients regarding out of pocket amounts is required. Identification of accounts that have been either under or over paid, issuing credit balance information either to the insurance carrier or the patient.
All of these practices done in a professional and communicative manner, per policies and procedures, guidelines, internal control measures and established goals. . Candidate must be a team player, and have ability to communicate well with direct reports, patients, customers, insurance carriers, etc. Ability to manage accounts worked independently, and in a productive manner.
Must project a professional demeanor and appearance while maintaining the confidentiality of the surgery center and patients. Works well in stressful environment and in situations that demand patience. Projects a professional demeanor and appearance while maintaining the confidentiality of administration, patients, physicians and employees.
Works under stress and in situations that demand patience and tact while providing impeccable service.
Day Hours: Monday – Friday 8 a.m. to 5 p.m.
EDUCATION, TRAINING AND EXPERIENCE
2-3 years previous collections experience, with emphasis on healthcare insurance collections of all types. Preference shown to previous experience in an ambulatory surgical setting. Medical terminology.
Prefer previous experience working with Advantx. (Patient Accounting System) Ability to work independently. Excellent communication skills and interpersonal skills.
Skilled in time management and prioritization of emergent situations. Good customer service skills, always demonstrates professionalism. Comfortable utilizing critical thinking skills.
Typing 45-60 WPM. High School Diploma or equivalency. Proficient with Microsoft Office products.
Experience with electronic patient information systems. Prefer previous experience with Electronic Health Record system but will train.
About the role
Under the direction of the Business Office Manager, the Collections Specialist is responsible for follow up on delinquent surgery center claims), working an expected number of claims per day. Majority of claims will have been submitted to various insurance carriers electronically. Knowledge of how to interpret a managed care contract, Medicare and Medicaid and Workers Compensation claims is a must.