Collections Specialist

Overall Responsibility:

Performs all appropriate collection activities to obtain full reimbursement and payment from patients and third-party payers.

Key tasks and responsibilities (essential functions):

• Maintain and work all facility accounts, meeting all collection activity schedules as established by the Manager.
• Refer difficulties or problems involving billing and collection efforts immediately to the Manager.
• Utilize collection evaluation tools regularly to meet cash collection goals, following through to completion on all patient and insurance questions and problems. Ensure complete and proper documentation in the system.
• Monitor accuracy, timeliness and completeness of patient accounts, including; demographic, insurance, referral and pre-certification information.
• Maintain complete and accurate files of all insurance information and contracts. Keep abreast of insurance changes and requirements. Ensure that up-to-date carrier information is maintained in the computer.
• Audit all EOBs to ensure accuracy of reimbursements and proper adjustments have been made.
• Complete all correspondence, rebill, denials and appeal processes as needed.
• Maintain and handle maintenance of system relating to patient accounting.
• Maintain expert knowledge of A/R system and A/R system reports.
• Maintain adequate computer supplies on hand, e.g., paper, insurance forms, ribbons, etc.
• Maintain updates and modification of all code books as published.
• Review all Medicare cases to ensure compliance.
• Help maintain patient confidentiality standards for both medical and financial information.
• Keep job related skills current through training programs.
• Participate in all compliance programs.
• Participate in loss prevention by protecting company assets and maintaining a safe environment.
• Performs other related duties incidental to the work required in this job description.

High school diploma or equivalent required. Minimum one-year experience in billing/patient account management in a healthcare setting. Proven knowledge of correct collection practices, knowledge of Medicare Compliance billing guide, Medicare/Medicaid and Managed Care contracts preferred. Knowledge of global and bundling coding guidelines helpful. Good interpersonal skills, excellent telephone etiquette, good verbal and written communication skills. Detail oriented with good organizational skills and ability to maintain accuracy while meeting daily deadlines. Good personal credit report.