Spartanburg Regional Healthcare System

About Spartanburg Regional Healthcare System


Job Category:

Business Services

Approximate Salary:

Not Specified

Position Type:

Full Time


Spartanburg Regional Healthcare System - Spartanburg, South Carolina

Posted: 08/9/2018

Salary: Job Grade 11

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. Duties include-<?xml:namespace prefix = "o" />

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.

Education Requirements

High School Diploma or equivalency

Experience Requirements

  • Three 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 of claims processing.
  • Solid skills with Microsoft Office with a focus on Excel and Word.
  • Good communication skills.

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