Medical Collections Specialist
Surgery Partners, Inc
full-time
Posted on:
Location Type: Hybrid
Location: Addison • Texas • United States
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About the role
- The primary responsibility of the Medical Collection Specialist is to ensure effective collection of all patient accounts.
- Perform extensive insurance claim follow-ups for insurance denials, appeals, and perform next steps a must.
- Ability to utilize multiple patients accounting and billing applications including but not limited to claims clearing house systems, payer websites.
- Ability to interact with the payer representatives, HIM, Insurance Verification and Access Service departments.
- Participates in group meetings and /or various committees.
- Ability to effectively present information regarding denial trends, and present to management.
- Ability to read, understand, interpret and resolve payer denials and EOB's.
- Ensure denial reviews, claim follow-ups are conducted in a timely manner in accordance with payer timely filing limits.
- Correct claims and file appeals with supporting documents to insurance companies, by phone, electronically or mail.
- Ability to work receivables to investigate and resolve denials and partial payments.
- Ability to calculate reimbursement per payer contract.
Requirements
- High School Diploma
- 3 to 5 years previous experience in office billing and collections
- High degree of attention to detail and accuracy
- Ability to prioritize work assigned independently and multi-task
- Knowledge of insurance, billing terms, CPT/ICD10, coding and DRG
- Knowledge of modifiers usage and CCI edits
- Strong medical insurance background
- Working knowledge of MS Office applications
- Critical thinking skills
- Spine/Orthopedic surgery experience preferred
- EPIC experience preferred
- Minimum of three years’ experience in medical collections.
- Hospital Billing/Collections preferred
Benefits
- Hybrid working arrangement
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
insurance claim follow-upsbilling applicationsclaims clearing house systemsCPT codingICD10 codingDRGmodifiers usageCCI editsreimbursement calculationmedical collections
Soft Skills
attention to detailaccuracyprioritizationmulti-taskingcritical thinkingpresentation skills