Job Details

Summary of Job

The role of a Collection Specialist in the Revenue Cycle Management department is to follow up on any unpaid insurance claims.

Essential Duties and Responsibilities
• Working of aged accounts
• Complex denial research
• Participate in client meetings
• Answer patient, client, or insurance carrier questions regarding claims
• Maintain the strictest confidentiality in accordance with all HIPAA guidelines/regulations
• Stay abreast of code changes, updates to reimbursement guidelines, and coverage policies

Skills & Requirements

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required including computer skills/level.
• Working knowledge of healthcare code sets
• Working knowledge of clean claim practices
• Working knowledge of the adjudication process
• Ability to research and follow claims appeal guidelines/processes
• Understanding of the complete healthcare revenue cycle
• Understanding of provider contracts and credentialing
• Understanding of basic accounting functions
• Proficient in Microsoft Outlook, Word, Excel
• Organized and detail-oriented

Education and/or Experience

Previous experience in a healthcare billing capacity required. Previous experience with hospital based follow-up desired. Previous experience with electronic health records/practice management system desired.

Language Skills

Employees are required to speak, read and write English

Certificates / Licenses / Registrations

None required, coding certificates desirable (CPC, CCS-P, CCS, etc.)

Physical Demands / Work Environment

All employees must be able to lift 50lbs