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

 

 

• 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

 

   

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

 

 

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.

 

 

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