Collection Specialist

Job Description

The collection specialist is responsible for ensuring accurate billing, timely submission of electronic and/or paper claims, monitoring claim status, researching rejections and denials, documenting related account activities, posting adjustments and collections of different insurance payers. The collection specialist must possess critical thinking skills and understanding of insurance payer payment methods to correctly record contractual adjustments base on payer contracts or government regulations. In addition, the medical billing and collection specialist must demonstrate proficiency with billing system to ensure all functionality is utilized for the utmost efficient processing of claims.

MAJOR DUTIES & RESPONSIBILITIES:

• Must have strong working experience with Microsoft Excel.
• Responsible for charge and payment entry within Electronic Health Record.
• Coordinates and clarifies with providers, when necessary, on information that seems incomplete or is lacking for proper account/ claim adjudication
• Responsible for correcting, completing, and processing claims for all payer codes
• Analyse and interpret that claim are accurately sent to insurance companies
• Perform follow up with Medicare, Medicaid, Medicaid Managed Care, and insurance companies on unpaid insurance accounts identified through aging reports
• Process appeals online or via paper submission

QUALIFICATION REQUIREMENTS:

• Minimum of two years of related experience in a business or healthcare industry
• Ideally the resource should have some management experience or at least lead experience
• Experience with an Electronic Medical Record
• Understanding of medical terminology and insurance laws/guidelines
• Excellent organization and time management skills along with excellent oral and written communication skills
• Strong team player
• Ability to learn quickly, build and maintain long term relationships and work with minimal supervision