Healthcare Collections Specialist

2 weeks ago


El Segundo, United States Evolve Treatment Centers Full time
Job DescriptionJob DescriptionDescription:

The Collections Specialist helps accomplish company goals by providing resolution and service to outstanding receivable accounts. The ideal candidate has passion and drive, intelligence and integrity, high attention to detail, professionalism and excellent follow up skills to increase revenue.

The position requires a thorough knowledge of the healthcare industry and an effective strategy working with insurance carriers to get claims paid.

Responsibilities:

  • Provides claim resolution for assigned accounts to increase collections and reduce delinquencies
  • Analyzes Explanation of Benefits and Remittance Advices and ensures claims processed according to members plans
  • Identifies denial reasons, and follows appeal process to get claims paid
  • Performs high volume collection phone calls to insurance companies
  • Meets minimum ‘time on the phone’ requirements
  • Accesses payer online resources to expedite claims follow up and ensure claims are on file and processing
  • Follows EOB protocol, retrieve documentation to ensure paid accounts are closed
  • Accesses billing software to analyze rejection reasons and communicate findings
  • Communicates billing/coding errors and completes resubmission request
  • Identifies and reports changes and trends in carrier guidelines and reimbursement patterns
  • Executes and delivers special projects from management and other duties as assigned
  • Corresponds with third party rate negotiation companies to expedite claim process
  • Accesses EMR, retrieves medical records and follows protocol
  • Adheres to documentation protocol, notates accounts and reports appropriately
  • Organizes daily and weekly production/action reports in file share
  • Participates in companywide and departmental meetings
  • Commits to providing excellent customer service while maintaining the highest degree of professionalism while working in a team environment to meet goals
  • Understands and complies with all HIPAA rules and regulations
Requirements:
  • 3-5 years High Volume corporate Collections experience
  • Knowledge of Billing and Collections procedures
  • Experience working with online payer resources
  • Accounts Receivable knowledge/experience a plus
  • Strong attention to detail, goal oriented
  • Commitment to excellent customer service
  • Ability to work efficiently within deadlines
  • Excellent written and verbal communication abilities
  • Strong interpersonal skills and ability to work in a team environment
  • Ability to prioritize and manage multiple responsibilities
  • Adheres to all policies and procedures as outlined in the Employee Handbook
  • Proficiency using Microsoft Office products

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