Collections Specialist
The Collections 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). The Specialist works with insurance companies, clients, and customers to resolve collection issues and reconciles accounts.
Key Responsibilities :
- 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
Other Responsibilities :
Manage assigned accounts and ensure the timeliness and accuracy of billing, collections, and payment activityDocument 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 accountsAlert the Manager of Collections of potential payment issuesRecommend adjustments / write-offs to the Manager of Collections and receive approval prior to reconciling accountsInvestigate refund requests related to accounts and complete refund paperwork for accounts that need to be refundedMeet the expectations and goals for productivity and cash targets as set forth by managementStay abreast of state, federal, and third-party funding regulations for assigned accounts ensuring billing and payment practices comply with third party payer requirementsPerform various other tasks as assignedMinimum Qualifications :
High School Diploma2 or more years of computer, accounting, collections, and high-volume medical billing and / or insurance claims processing experienceKnowledge of payment posting process in regard to contractual adjustments and refunds preferredKnowledge of medical insurance claims procedures and documentation preferredCommunication Skills :
Strong customer service and interpersonal skillsOral and written communication skillsTeaming skillsComputer or Technical Skills :
Proficient in M.S. Office Word, Excel, and OutlookAble to research claim information via the internetBasic data and word processing skillsOther Skills Requirements :
Apply independent judgment and manage confidential informationAbility to gather data and summarize informationTime management and good organizational skillsExcellent problem solving skillsRecord managementPhysical Requirements :
See, hear, and speakKneel, stand, and reachAbility to lift and / or move up to 10 poundsWork Environment Requirements :
Ability to work at a desk for prolonged periods of timeAbility to work with interruptions in a fast-paced environmentAbility to travel to the Pittsburgh office for team activities / trainings (approx. 4 times per year)