Collections Specialist
Division : Billing
Location : Denver Branch, Centennial CO US 80112
Career Level : Experienced (Non-Manager)
Job Type : Full Time
Education : High School or equivalent
Skill : Accounting -> Collections
Job Description :
Job Title: Collection Specialist

Reports to: Reimbursement Manager/Supervisor


Summary:

The Collection Specialist is responsible for a broad range of collection processes related to medical accounts receivable in support of single or multiple site locations. The employee will proactively work assigned accounts to maximize accurate and timely payment. The employee will observe company policies and all applicable laws and regulations regarding the collection of medical claims and patient balances. The employee must have the ability to prioritize, problem solve, and multitask. The employee will work closely with other staff to identify, resolve, and share information regarding payer trends and guideline updates. Above all, qualified candidates should possess exceptional internal and external customer service skills and actively promote Amerita’s company culture.

Essential Duties and Responsibilities:

 Insures daily accomplishments work towards company goals for cash collections and A/R over 90 days
 Understands and adheres to state and federal regulations, and to company policies regarding to compliance, integrity, patient privacy and ethical billing and collection practices
 Understands and adheres to HIPAA and PHI guidelines
 Researches outstanding balances and takes necessary collection action to resolve in a timely manner; makes necessary demographic changes to patient accounts to insure future collections
 Resubmits accurate and timely claims in formats including but not limited to CMS-1500, and electronic 837
 Utilizes most efficient resources to secure timely payment of open claims or invoices; electronic solutions should be given priority
 Negotiates payment plans with patients in accordance with company collection policies
 Identifies patterns of short-payment or non-payment and brings them to the attention of appropriate supervisory personnel
 Reviews insurance remittance advices for accuracy. Identifies billing errors, short payments, over payments, unpaid claims, and resolves accordingly communicating any needed system changes
 Reviews residual account balances after payments are applied and generates necessary adjustments (within eligible guidelines), overpayment notification, refund request, and/or secondary billing as needed
 Interacts with third party collection agencies as needed
 Communicates consistently and professionally with other Amerita employees
 Works within specified deadlines and stressful situations
 Works overtime when necessary to meet department goals and objectives
 Performs other tasks or special projects as requested by management



Knowledge and Skill Requirements:

 A minimum of 1-2 years experience in medical collections with a working knowledge of managed care, commercial insurance, Medicare and Medicaid reimbursement; home infusion experience a plus
 Working knowledge of automated billing systems, experience with CPR+ preferred
 Working knowledge and application of metric measurements, basic accounting practices, ICD-9, CPT and HCPCS coding
 Solid Microsoft Office skills required: Word, Excel and Outlook
 Ability to type 40 wpm and proficiency with10-key calculator
 Ability to independently obtain and interpret information
 Strong verbal and written communication skills

Education/Licenses/Certificates required:
 High School diploma or GED equivalent required.
 Some college a plus 

 

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Amerita is an Affirmative Action/EEO Employer