Medical Collections Specialist

You, as the Medical Collections Specialist will perform designated billing and collection activities for assigned agencies to ensure receivables are reimbursed in an accurate and timely manner. You’ll also be working directly with the payer and internal and external customers towards efficient and effective collection results.

•Ensures the coordination of billing and collection activities for designated agencies, leading to the timely reimbursement of receivables using available resources including databases, internet, and telephone.

•Researches and identifies root cause of denials/rejections received daily, which have not passed payer edits. May utilize various agency/vendor systems and payer websites.

•Determines and initiates action to resolve denied/rejected invoices and prepares payer corrections and/or appeals using electronic and paper processes.

•Communicates with agencies to educate them concerning the importance of clean claims.

•Analyzes and clears payment variances. May prepare adjusted and corrected bills, adjust accounts receivable entries, or prepare refunds in accordance with existing operating procedures.

•Obtains appropriate clinical documentation and billing information to substantiate services provided and provide copies of documentation to payers as requested.

•Provides input on accounts receivable plans and process improvement, assisting in their implementation.

•Prepares special handling and/or reconciliation spreadsheets for payers and/or clients.

•Adheres to and participates in Company’s mandatory HIPAA privacy program / practices and Business Ethics and Compliance programs / practices.