Medical Collections Specialist
1 week ago
Casa de la Familia is seeking a proficient and knowledgeable medical collections specialist who can consistently drive revenue through ethical billing practices and effective collection strategies. The ideal candidate will have a strong background in collections related to workers compensation and personal injury cases, particularly in negotiation and representation in legal settings.
Key Responsibilities
The medical collections specialist will be tasked with preparing and submitting patient invoices for both insurance and private payments. Acting as a liaison between patients and their health insurance providers, maintaining professionalism and compliance with all debt collection regulations is essential.
Responsibilities include managing billing and collections, addressing claim denials, overseeing patient accounts, and performing various administrative tasks. You will be responsible for all debt-related issues and will regularly communicate with insurance companies and patients to facilitate payment collection.
Specific Duties Include:
- Preparation and submission of insurance claims
- Determining, correcting, and submitting billable claims
- Processing accounts
- Analyzing information
- Verifying authorization and diagnosis codes
- Preparing batches for posting
- Generating and reviewing reports
- Managing patient accounts
- Appealing denied claims
- Responding to patient inquiries regarding insurance coverage and benefits
- Establishing repayment plans with patients in arrears
- Contacting insurance billing departments to rectify billing discrepancies
Qualifications
The successful candidate should possess the following skills and qualifications:
- Understanding of medical terminology
- Knowledge of legal compliance
- Strong documentation abilities
- Experience in accounts receivable and payable
- Familiarity with medical billing software
- Knowledge of Explanation of Benefits (EOB)
- Understanding of various insurance plans, including Medicare
- Strong organizational skills and attention to detail
- Excellent communication skills, particularly over the phone
- Exceptional negotiation capabilities
- Ability to thrive in a high-pressure environment
- High school diploma or GED required
- Preferred: College degree
- Required: Prior experience in medical billing and collections
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