Collection Specialist
3 weeks ago
**The Collections Specialist **ensures that all collection activity is performed and completed accurately. This position is responsible for timely filing and following up with insurance payors on submitted claims that have not been paid so as to have a fluent revenue cycle.
**Essential Functions**:
- Review, understand, and work unpaid and denied claims using QMS aging reports and clearinghouse worklists and reporting tools
- Recognizing trends in the aging reports and working with payers to decrease response/payment turnaround
- Initiates appeal requests per payer guidelines
- Research and understand payer contracts; identify timely filing and appeal deadlines
- Manage any worklists and reports in the external clearinghouse for unpaid or denied claims
- Maintaining follow up notes in QMS
- Working knowledge of Clinical EMR, billing system and any external clearinghouses used
- Exceptional customer service with all payers
- Insuring the confidentiality of patients and employee information in compliance with HIPAA guidelines
- Contributing to harmonious and constructive working relationships with all staff members to promote a positive and productive atmosphere
The essential functions listed are not a comprehensive inventory of all duties, tasks, and responsibilities. Employees may also perform other duties as assigned. All employees must work in accordance with Satellite's I-CARE Standards. Employees must abide by all Satellite's standards of patient care, patient's rights and ethical treatment, and adhere to safety and quality programs.
**Minimum Education & Experience**:
- High School Diploma, GED or equivalent required; college courses or courses in insurance billing, data processing, or medical terminology preferred
- Two (2) years of experience in a medical collections environment
Any combination of education and experience that would likely provide the required knowledge, skills, and abilities as well as possession of any required licenses or certifications is qualifying.
**Minimum Knowledge, Skills & Abilities**:
- Ability to analyze data
- Exceptional customer service to all clients
- Contributes to harmonious and constructive working relationships with all staff members to promote a positive and productive atmosphere
- Accurate keyboard and ten-key skills; must be literate in Microsoft based programs
- Ability to work effectively in a team environment and independently
- Positive attitude with excellent interpersonal skills
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