Medical Collections Specialist

3 days ago


Dallas, Texas, United States SCP Health Full time
Medical Collections Specialist

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 crucial role in our revenue cycle services team, working to ensure reimbursement goals and days in accounts receivable are maintained or achieved.

Key Responsibilities:
  • 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
  • Prepare reports for management denial and rejection trending reports and facility analysis
  • Provide regular feedback to management, based on research and calls to payers, to establish payer behavior trends
  • Produce a minimum of 55 outcomes per day on Medical Collection Views
  • Achieve a minimum score of 90% on Quality Assurance audits
Requirements:
  • Understand the overall revenue cycle process through final adjudication of accounts
  • Detail-oriented, organized, and enjoy working in a team environment that is metric-focused
  • At least 3 years of direct Medical Insurance Denials Management experience, Central Billing Office experience preferred
  • Experience working Provider Emergency Medicine and/or Provider Hospital Medicine claims preferred, Provider Worker's Compensation claims experience is also a plus
  • Experience adjudicating medical claims from Government and/or Commercial payers
  • Tech-savvy with Medical Billing Systems experience, experience with AthenaIDX and/or OnBase a plus and have EMR experience
  • Microsoft Office experience with at least intermediate Excel and Outlook skills and beginner Word skills
  • High school diploma or GED required

SCP Health is an Equal Opportunity Employer. We value diversity and inclusion in the workplace. If you're passionate about making a difference in the healthcare industry, we encourage you to apply for this exciting opportunity.



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