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.
High School Diploma or equivalency
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.