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Healthcare Collections Specialist

2 months ago

Dallas, Texas, United States MedicalWorx Staffing Full time
Job Overview

Position Summary:

The Healthcare Collections Specialist is a vital role within our organization, tasked with the recovery of funds owed by patients and insurance providers.

Reporting Structure:

This position reports directly to the Billing and Collections Director.

Key Responsibilities:

  1. Conduct thorough follow-ups on accounts to secure anticipated payments from all sources, including regular reviews of outstanding balances and the correction and resubmission of denied claims.
  2. Identify overdue accounts and execute collection actions, which may involve contacting patients or resubmitting claims to third-party payers.
  3. Address customer inquiries regarding account statuses, utilizing various information sources for account reviews.
  4. Collaborate with the collections team to ensure complete recovery of all accounts.
  5. Evaluate accounts for potential transfer to collection agencies.
  6. Accurately document all collection activities in the billing system.
  7. Review guarantor accounts for accuracy before dispatching monthly statements.
  8. Maintain detailed records of patient interactions and insurance follow-ups, ensuring all information is current and precise.
  9. Analyze and resolve issues related to rejected or underpaid claims, facilitating resubmissions for payment.
  10. Address and resolve patient billing complaints effectively.
  11. Participate in ongoing education programs as designated by management.
  12. Ensure timely follow-up on outstanding accounts.
  13. Verify the accuracy of insurance overpayment requests and appeal any incorrect refund requests.
  14. Review insurance Explanation of Benefits (EOBs) and initiate the appeal process as necessary.
  15. Manage both electronic and paper claim rejections.
  16. Ensure prompt submission of all secondary and tertiary claims.
  17. Complete reports generated by supervisors within established deadlines.
  18. Work collaboratively with front office and billing personnel to address claim denials and billing discrepancies.
  19. Alert supervisors to any potential compliance issues.
  20. Monitor and report on insurance changes that may affect timely and accurate billing and reimbursement.
  21. Adhere to the Fair Debt Collection Practices Act (FDCPA).
  22. Perform additional billing and collection tasks as assigned by supervisors.

Qualifications:

Education: High School Diploma or equivalent.

Experience: Minimum of one year in medical insurance billing and collections.

Knowledge and Skills:

  1. Familiarity with ICD and CPT coding.
  2. Understanding of practice policies and procedures.
  3. Proficiency in relevant computer programs and applications.
  4. Knowledge of the Fair Debt Collection Practices Act (FDCPA).

Skills:

  1. Effective written and verbal communication skills.
  2. Strong problem-solving abilities.
  3. Excellent customer service skills.
  4. Mathematical proficiency.
  5. Strong organizational and planning skills.

Abilities:

  1. Ability to communicate clearly and effectively.
  2. Ability to listen and respond to inquiries appropriately.
  3. Ability to write clearly and informatively.
  4. Ability to interpret written information accurately.
  5. Ability to gather and analyze information to resolve issues promptly.
  6. Ability to manage challenging customer interactions with professionalism.
  7. Ability to perform calculations involving percentages, coinsurance, deductibles, and discounts.
  8. Ability to prioritize tasks and manage time efficiently.
  9. Ability to maintain confidentiality in all matters.
Company Overview

MedicalWorx Staffing is dedicated to ensuring that our employees' performance meets or exceeds productivity expectations. We strive to positively impact your organizational culture and enhance our value to your company. Our services include providing skilled and qualified personnel for temporary, contract-to-hire, or direct hire positions, as well as payroll services.