Customer Service Medical Collections Specialist

4 weeks ago


Livermore, United States NORCAL-Ambulance Full time

**Description**:

- Excellent oral and written communication skills.
- Customer service experience to resolve billing problems.
- Be hardworking, punctual, accurate, and detail oriented.
- Bilingual is a plus. (not required)**

**collection efforts, payment posting, medical coding corrections, billing corrections and appeals, claim**

**submissions, medical insurance communications, PT billing collections and other duties in our accounts**

**receivable department.**

**Responsibilities**:

- Work directly with insurance companies and patients to get claims processed and paid.
- Customer service, answering phones calls to collect payment and answer question regarding claims.
- Initiate collection follow-up of all unpaid or denied claims with the appropriate payor.
- Respond to written or electronic payor communications with appropriate action in a timely manor.
- Contact insurance companies regarding discrepancies in payments.
- Maintain multiple workflows to process claims as efficiently as possible.
- Reviewing and appealing denied and unpaid claims.
- Assist patients in appealing denied claims.
- Prepare and submit claims as needed, and rectify claims in a timely fashion if necessary.
- Prepare materials to be sent to insurance companies, as directed.
- Keep accurate and detailed notes on all activity.
- Understanding of payer guidelines for Medicare, Medi-Cal (and its affiliates), Commercial Insurance, Workers Compensation, and various other insurance carriers.
- Maintain strictest confidentiality; adhering to all HIPAA guidelines/regulations.
- Collect delinquent accounts by establishing payment arrangements with patients and also follow-up with patients when payment lapses occur.
- Sort correspondences and other letters and routes to the most appropriate recipients as applicable.
- Works various assigned tasks in billing system.
- Assist with assigned projects that pertain to the revenue cycle under the direction of the management team.

**Job Requirements**:

- Excellent customer service skills.
- Medicare, Medi-Cal, commercial insurance knowledge preferred.
- Proficient with Microsoft suite.
- Excellent attention to detail and the ability to troubleshoot/problem solve.
- Critical thinking on every aspect of claim submission.
- Ability to work both independently and in a team.
- Position is located on-site in Livermore, not a remote position.



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