Billing and Collections Specialist

1 week ago

Clearwater Florida, United States CCS Full time

Overview:


Are you seeking a meaningful career that positively impacts the patient community? At CCS, we are transforming at-home patient care through innovative chronic care management.

We are in search of individuals who excel in a patient-focused, dynamic environment.

If you possess strong listening skills, quick thinking, and problem-solving abilities, and can connect with diverse individuals, you may be the perfect fit for CCS.

As a Billing and Collections Specialist, your role will involve managing claim submissions and resolutions for CCS Medical patients, encompassing governmental and commercial insurance entities as well as patient accounts.


Responsibilities:
Manage a personal portfolio of accounts within the CCS Medical billing and collections framework.

Evaluate insurance reimbursements for individual supplies to ensure optimal returns.

Confirm that all necessary supporting documentation is secured prior to shipment and/or billing.

Review the configuration of supplies based on supporting documents, formulary requirements, and manufacturer compatibility.

Record payments and/or adjustments to individual accounts.

Address credit balance accounts as required.

Identify issues or areas for improvement within your domain, devising resourceful and alternative solutions for work enhancement or problem resolution.

Investigate and follow up on all correspondence related to assigned accounts, including EOBs and documentation letters, and generate requests for required information when necessary.

Initiate appeals and ensure all necessary documentation is submitted during the appeals process. Investigate all denials and follow up as needed.

Handle inbound and outbound communications with insurance companies and patients to collect outstanding funds.

Minimize delinquent accounts while maximizing collections from all sources.

Generate reports to identify trends or problematic carriers, pinpoint areas of concern, and propose corrective measures to prevent future issues.

Analyze and rectify accounts receivable challenges.

Document all activities thoroughly.

Meet productivity targets based on accounts managed, funds collected, and aging periods.

Report any issues to management as necessary.

Maintain a high level of confidentiality at all times due to access to sensitive information.

Qualifications:
High school diploma or GED equivalent required.

A minimum of two years of experience in medical billing and collections is essential. Familiarity with reimbursement processes and procedures is necessary.

Ability to collaborate with colleagues and provide assistance as needed.

Proficient in basic computer skills (MS Office).

Demonstrated organizational skills, accuracy, and attention to detail, coupled with strong analytical capabilities.

Ability to work effectively in both team settings and independently.

Excellent verbal and written communication skills.

Self-motivated with the capacity to work with minimal supervision.

Adaptable and cooperative in fulfilling all responsibilities.

Ability to interpret regulations set by Medicare, Medicaid, and commercial payors.

Willingness to learn and grow as the company evolves.

Capability to recommend and implement process improvements for efficiency.


Ability to read and interpret documents such as safety rules, operating instructions, and procedure manuals; ability to write routine reports and correspondence; ability to communicate effectively before groups of customers or employees.


Values:
Values

Certainty - The lives of those we serve depend on our ability to execute effectively. We commit to this every day.


Utilize appropriate methods and a flexible interpersonal style to foster a cohesive and collaborative team built on trust and transparency.

Deliver on your commitments.


Compassion - We recognize the challenges faced by patients and their families, driving us to pursue customer satisfaction relentlessly in every aspect of our business.


Ensure that patient needs guide our business decisions, implementing service practices that address the needs of both patients and the organization.

Treat others as you wish to be treated.

Advancement - We are continuously seeking ways to innovate and improve in all our endeavors.

Encourage creative approaches to tackle opportunities and facilitate change, promoting cross-functional alignment to achieve goals. Speak the truth.

CCS Medical is an EEOC/AA employer. M/F/D/V

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