Collection Specialist
This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more.
Role Description
The Collection Specialist supports the effective management of the revenue cycle process and ensures the accurate and timely collection of sales to third party payers (including Medicare, Medicaid, Private Insurance, and other funding sources).
Manage assigned accounts and ensure the timeliness and accuracy of billing, collections, and payment activity
Verification that a claim is on file
Follow up with the payer due to lack of payment
Investigation of denials
Coordination with the billers to address billing issues
Coordination with the funding consultants to address documentation questions
Preparation of correspondence, such as appeals, to fight for the payment of accounts, request different denial codes, etc.
Review of posted payments for accuracy and investigate differences
Document in the system all verbal and written communication relative to collection actions and expected outcomes of overdue accounts
Follow up every 30 days with insurance companies, clients, SPLs, and vendors to ensure the payment of accounts
Alert the Manager of Collections of potential payment issues
Recommend adjustments/write-offs to the Manager of Collections and receive approval prior to reconciling accounts
Investigate refund requests related to accounts and complete refund paperwork for accounts that need to be refunded
Meet the expectations and goals for productivity and cash targets as set forth by management
Stay abreast of state, federal, and third-party funding regulations for assigned accounts ensuring billing and payment practices comply with third party payer requirements
Perform various other tasks as assigned
Qualifications
High School Diploma
2 or more years of computer, accounting, collections, and high-volume medical billing and/or insurance claims processing experience
Knowledge of payment posting process in regard to contractual adjustments and refunds preferred
Knowledge of medical insurance claims procedures and documentation preferred
Requirements
Strong customer service and interpersonal skills
Oral and written communication skills
Proficient in M.S. Office Word, Excel, and Outlook
Able to research claim information via the internet
Basic data and word processing skills
Apply independent judgment and manage confidential information
Ability to gather data and summarize information
Time management and good organizational skills
Excellent problem solving skills
Record management
Work Environment Requirements
Ability to work at a desk for prolonged periods of time
Ability to work with interruptions in a fast-paced environment
Ability to travel to the Pittsburgh office for team activities/trainings (approx. 4 times per year)
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