Healthcare Collections Specialist

Description

• Ensure that the organization receives all necessary payments at the correct, and contracted rate from each consumer insurance company
• Review insurance carriers’ denial reports, remittances, and correspondence to find issues preventing payment
• Analyze accounts receivables and collections data, in search of trends and patterns to improve billing, collections, and DSO results
• Resolve consumer insurance balances by analyzing denials and using critical thinking skills and knowledge of payor requirements to determine the steps needed to obtain payment
• Based on payer processes, utilize payer portals, paper/electronic remits and/or place calls to the payer to understand and resolve denials
• Review data on insurance authorizations to ensure accurate claim processing and payment
• Work accounts holistically, building on the last intervention and not repeating tasks
• Complete projects assigned for specific payers or specific types of accounts, ensuring deadlines are met
• Strive to achieve and maintain company Days Sales Outstanding and Account Receivable aging standards
• Create a tickler file to ensure timely follow-up of outstanding claims/balances consistent with the timely filing limits of the payors
• Develop and submit appeals, including supporting documentation as needed
• Prepare a weekly report with status updates and communication taken on problem accounts
• Ability to manage daily job functions along with special project work and prioritize the level of importance on demand
• Uphold the strictest confidentiality and adhere to all HIPAA guidelines/regulations
• Keep accurate and thorough records of all communications and follow-up relating to the accounts that the position is responsible for
• Perform other duties as assigned by management.

• At least two years’ experience, preferably with a background in admissions, social services, administration, and/or public relations
• High school diploma or equivalent, Bachelor’s or associate degree preferred
• Familiarity with Social Security and Medicaid
• Knowledge and understanding of local and regional regulatory operations
• Knowledge and understanding of state regulations
• Experience with intake and admissions
• Working Knowledge of ICD-10 codes
• Therap experience is a plus
• Proficiency in Microsoft Outlook, Word, and Excel
• Employment is contingent upon successful completion of checks of criminal background, central registry, child abuse registry, and drug testing

• Competitive Insurance Benefits (Medical, Dental, Vision)  
• Paid Holidays—Including a Birthday Holiday  
• Generous PTO  
• Employee Incentive & Discount Programs  
• 403b Retirement Plan  
• Incredible career growth opportunities  
• University partnerships that include tuition reduction