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Hospital Collection Specialist
4 months ago
**JOB SUMMARY**
This position requires a driven individual that can multi-task, problem solve, and manage workload and time effectively. This involves performing collection activities related to follow-up and account resolution, and includes communication to patients, clients, reimbursement vendors, and other external entities while adhering to all guidelines. Patient and client satisfaction is essential.
**DUTIES AND RESPONSIBILITIES**
- Possesses thorough understanding of the hospital revenue cycle with specialization in hospital billing, follow-up, and the account resolution process.
- Communicates with patients to help them resolve their healthcare accounts.
- Receives and properly handles incoming phone calls by assisting patients with their questions or concerns, arranging payment arrangements, and obtaining insurance information from patients.
- Collects and processes payments over phone.
- Makes outbound calls in an effort to resolve the patient account.
- Document all collections activity performed on each account in the system.
- Reviews general accounts receivable incoming correspondence and takes timely and appropriate action.
- Analyzes account for errors, adjustment, credits, issuing corrected entries when required. Escalates complex issues. Updates account information.
- Manage multiple work queues for follow-up and denials by engaging payor websites and initiate calls to ensure prompt payment of medical claims. Pursues and/or follow-up on appeals. Initiate communication with coding team and clinical staff when coding related, and medical necessity appeals are warranted.
- Identify denial trends and notify Supervisor and/or Manager to prevent future denials and further delay in payments. Makes recommendations for resolution.
- Maintains positive working relationships and fosters a cooperative work environment. Adheres to the hospital’s compliance program.
**REQUIREMENTS**
- High school diploma or GED.
- Some College, Associate’s Degree or higher preferred.
- Minimum two years' medical office experience.
- One year of relevant experience in Acute Care setting.
- Experience with collections in healthcare revenue space is preferred.
- Multi-Specialty insurance experience.
- Epic, Athena, or similar software experience highly desired.
**EDUCATION**
- High School Diploma or GED
- Some College, Associates, or Bachelor’s preferred.
**CERTIFICATION, LICENSURE**
- N/A
**KNOWLEDGE SKILLS & ABILITIES**
- Extremely conscientious with excellent organizational skills.
- Capable of working independently and as a team member.
- Must be very customer service oriented.
- Knowledge with in and out of network insurances, insurance verification, patient responsibility, and process for prior authorization.
- Ability to stay focused in a fast-paced environment, manage time efficiently, and able to multitask.
