Medical Collections Specialist

1 week ago


Englewood, Colorado, United States ResCare Full time
Collection Specialist

Amerita is seeking a highly skilled Collection Specialist to join our Revenue Cycle Management (RCM) team. As a key member of our team, you will be responsible for a broad range of collection processes related to medical account receivable in support of a single or multiple site locations.

Responsibilities:
  • Ensure daily accomplishments work towards company goals for cash collections and Account Receivable over 90 days.
  • Understand and adhere to state and federal regulations and company policies regarding compliance, integrity, patient privacy and ethical billing and collection practices.
  • Research outstanding balances and take necessary collection action to resolve in a timely manner; recommend necessary demographic changes to patient accounts to ensure future collections.
  • Research assigned correspondence; take necessary action to resolve requested information in a timely manner; establish appropriate follow up.
  • Resubmit accurate and timely claims in formats including, but not limited to, CMS-1500 and electronic 837.
  • Negotiate payment plans with patients in accordance with company collection policies.
  • Identify patterns of short-payment or non-payment and bring them to the attention of appropriate supervisory personnel.
  • Review insurance remittance advices for accuracy.
  • Identify billing errors, short-payments, overpayments and unpaid claims and resolve accordingly, communicating any needed system changes.
  • Review residual account balances after payments are applied and generate necessary adjustments (within eligible guidelines), overpayment notifications, refund requests and secondary billing.
  • Interact with third party collection agencies.
  • Communicate consistently and professionally with other Amerita employees.
  • Work within specified deadlines and stressful situations.
  • Work overtime when necessary to meet department goals and objectives.
Qualifications:
  • High School Diploma/GED or equivalent required; some college a plus.
  • A minimum of one (1) year of experience in medical collections with a working knowledge of managed care, commercial insurance, Medicare and Medicaid reimbursement; home infusion experience a plus.
  • Working knowledge of automated billing systems; experience with CPR+ preferred.
  • Working knowledge and application of metric measurements, basic accounting practices, ICD-9, CPT and HCPCS coding.
  • Solid Microsoft Office skills required, including Word, Excel and Outlook.
  • Ability to type 40 wpm and proficiency with 10-key calculator.
  • Ability to independently obtain and interpret information.
  • Strong verbal and written communication skills.


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