This position is responsible for the collection and rebilling of unpaid claims. The Collections Specialist understands the reimbursement process from intake/authorization to complete billing functions for all payment methods.
- Addresses and collects revenue on outstanding claims.
- Performs rebilling function of insurance payers within the collection process: commercial carriers, managed care, PPO, POS and HMO organizations.
- Responds to changes in patients insurance (plan changes, ID numbers, etc.), updates electronic records, and informs appropriate reimbursement departments.
- Reviews all denied claims and communicates with insurance carriers to facilitate collection of unpaid balances.
- The employee is frequently required to stand, walk, sit, and handle/finger.
- The employee is frequently required to reach outward, reach above shoulder, climb, crawl, squat, kneel and bend.
- The employee must be able to frequently push/pull 15lbs or less and occasionally push/pull up to 100lbs.
- The employee must be able to lift/carry up to 10lbs frequently and up to 50lbs occasionally.
- Specific vision abilities required by this job include close vision, distance vision, peripheral vision, and the ability to adjust focus.
- Work is normally performed in a typical interior/office work environment.
- The noise level in the work environment is usually quiet to moderate.
EDUCATION, TRAINING AND EXPERIENCE REQUIREMENTS
High school diploma or equivalent is required, Bachelor’s Degree is preferred; Minimum of one year experience of collections experience in infusion services or other healthcare profession; Minimum of one year customer service required; Excellent interpersonal, verbal & written communication skills and organizational skills required; Must be able to assume a flexible work schedule.
KNOWLEDGE, SKILLS, AND ABILITIES REQUIRED.
- Ability to understand insurance contracts.
- Possess working knowledge of medical terminology.
- Knowledge of HCPCS coding.
- Knowledge of electronic billing and requirements for assorted insurance plans.
- Ability to prioritize and handle multiple tasks and projects concurrently.
- Demonstrated knowledge and proficiency in the principles, procedures and best practices related to this position.
- Excellent verbal and written communication skills.
- Proficient level of software proficiency in using PC software to support activities, especially Microsoft Office.
- Strong interpersonal skills and the ability to interact well with all customers and employee levels.
- Ability to work with confidential material and maintain confidentiality along with sensitivity to employees and customers needs and data.
- Proficient attention to detail.
- Proficient analytical skills.
Ability to read, analyze and interpret information appropriate to duties and responsibilities assigned. Ability to operate information systems, follow policy, complete required forms, and prepare reports. Ability to effectively present information and respond to questions from patients, and payors.
Ability to perform basic mathematical calculations.
Ability to define problems, collect data, establish facts, and draw valid conclusions.