Medical Collections Specialist

2 days ago

Dearborn, Michigan, United States Sevita Full time
Job Title: Medical Collections Specialist

Sevita is seeking a highly motivated and detail-oriented Medical Collections Specialist to join our team. As a Medical Collections Specialist, you will play a critical role in ensuring the timely and accurate collection of medical claims from payers.

Key Responsibilities:
  • Review and work in Denial Workflow (DWF) for tasks with follow-up dates that are set to expire on that day and for tasks without a payer response once past 30 days from billing
  • Work credit balances on the aging and overpayment account and follow the credit balance procedure for resolution
  • Prepare appeal packet as required by payer, scan and save documentation to be sent, and update DWF with notes and a follow-up date
  • Update collection procedures as necessary
  • Review and work denials in workflow system, payer portal, and/or clearinghouse portal daily
  • Follow-up with Field on updates to items assigned to them that are past follow-up date
  • Update DWF with clear concise notes as claims are worked
  • Review unapplied cash log for any items that can be applied and work with cash team to resolve
  • Complete necessary forms and provide appropriate support for refunds, cash moves, sales adjustments, and transfer of liability
  • Ensure internal control compliance with all assigned areas and other audit requirements
  • Maintain an effective control environment for the accounting operations
Requirements:
  • High school diploma or equivalent required; Associate or Bachelor's degree in a finance-related field preferred
  • 2-3 years of experience with Medical Collections in a high-volume environment preferred
  • Knowledge of ICD-10 diagnosis codes, CPT medical service codes, UB-04, and HCFA-1500 forms
  • Strong understanding of medical collections compliance, Medicare, Medicaid, Medicaid managed care, Commercial, Workers Comp, and Auto-no-fault payer types
  • Self-motivated, detail-oriented, and highly organized with the ability to multi-task
  • Excellent communication skills, analytical skills, and the ability to collect information from multiple sources
  • Effectively use Microsoft Office
Why Sevita?

Sevita is a leading provider of home and community-based specialized health care. We believe that everyone deserves to live a full, more independent life. We provide people with quality services and individualized supports that lead to growth and independence, regardless of the physical, intellectual, or behavioral challenges they face.

We are committed to creating an inclusive and diverse workplace that values and respects the unique talents, experiences, and perspectives of our employees and the people we serve.

As an equal opportunity employer, we do not discriminate on the basis of race, color, religion, sex, national origin, age, disability, genetic information, sexual orientation, pregnancy, gender identity or any other characteristic protected by law.

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