Medical Collections Specialist Sr

6 days ago

Dallas, TX, United States SCP Health Full time
At SCP Health, what you do matters

As part of the SCP Health team, you have an opportunity to make a difference. At our core, we work to bring hospitals and healers together in the pursuit of clinical effectiveness. With a portfolio of over 8 million patients, 7500 providers, 30 states, and 400 healthcare facilities, SCP Health is a leader in clinical practice management spanning the entire continuum of care, including emergency medicine, hospital medicine, wellness, telemedicine, intensive care, and ambulatory care.

Why you will love working here:

- Strong track record of providing excellent work/life balance.

- Comprehensive benefits package and competitive compensation.

- Commitment to fostering an inclusive culture of belonging and empowerment through our core values - collaboration, courage, agility, and respect.

Medical Collection Specialists are responsible for promoting a patient-centric approach to working medical collections. This position manages accounts receivable balances for assigned facilities by reducing the AR to cash, resolving claim denials, providing direct oversight to payor and facility specific processes surrounding AR, and effectively working with a team of offshore staff to work Enterprise Task Manager tasks.

Responsibilities:
  • Responsible for all the Medical Collection Specialist functions as well as the responsibilities listed.
  • Lead the resolution of complex denials for professional emergency and hospital medicine services.
  • Analyze denial trends and collaborate with the team to implement proactive measures. This may include Provider Enrollment related task as well as Worker's compensation billing and follow up.
  • Conduct thorough audits of medical claims, ensuring compliance with coding standards and documentation requirements.
  • Provide detailed feedback to improve the accuracy and completeness of claims submissions.
  • Act as a senior figure in the team, providing guidance and expertise in denial management.
  • Collaborate with other departments to streamline processes and enhance overall revenue cycle efficiency.
  • Handle escalated denial issues that require advanced knowledge and experience.
  • Stay informed about changes in payer policies, regulations, and industry standards related to emergency room and hospital medicine services.
Knowledge, Skills, and Abilities:
  • Understand payer Explanation of Benefits and identify posting errors of payments and adjustments.
  • Must be extremely detail oriented and organized, a self -starter who is capable of meeting deadlines and goals.
  • Ability to work autonomously and as a team member, with little supervision once a goal is set.
  • Excellent verbal and written communications skills.
  • Requires manual dexterity sufficient to operate a computer keyboard, answer a telephone, and operate a copier and other office equipment as necessary.
  • Vision must be correctable to 20/20.


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