Medical Collections Specialist
1 week ago
At SCP Health, we're dedicated to bringing hospitals and healers together in the pursuit of clinical effectiveness. As a Medical Collections Specialist, you'll play a vital role in our revenue cycle process, ensuring reimbursement goals are met and days in accounts receivable are minimized.
Your Key Responsibilities:
- Support the general activities and claims adjudication of the Medical Collection department with denial management and appeals for designated rejections.
- Review Accounts Receivable (AR) by payer daily to ensure reimbursement goals and days in AR are maintained or achieved.
- Research and resolve invoices routed to the Specialists Views; to include Escalated Views, CE View, Correspondence View, Rejection View, etc.
- Prepare required appeals relating to past timely filing, medical necessity, and other denials.
- Provide regular feedback to management, based on research and calls to payers, to establish payer behavior trends.
- Document and ensure each SCP Health Special Arrangement is processed correctly and returning the expected results.
What We're Looking For:
- You have at least 3 years of direct Medical Insurance Denials Management experience, Central Billing Office experience preferred.
- You have experience working Provider Emergency Medicine and/or Provider Hospital Medicine claims preferred, Provider Worker's Compensation claims experience is also a plus.
- You have experience adjudicating medical claims from Government and/or Commercial payers.
- You are tech savvy with Medical Billing Systems experience, experience with AthenaIDX and/or OnBase a plus and have EMR experience.
Why SCP Health?
- We value people, process, and technology.
- We offer a flexible schedule and a strong track record of providing excellent work-life balance.
- We provide comprehensive benefits and competitive compensation.
- We foster an inclusive culture of belonging and empowerment through our core values - collaboration, courage, agility, and respect.
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