Collection Specialist, Full Time

Hialeah Hospital•Hialeah, FL

11d

About The Position

Under the supervision of the Vice President of Revenue Cycle or designee, performs patient account follow-up, credit balance review and resolution, keeping the hospital's accounts receivable as accurate as possible.

Requirements

High School graduate or equivalent
Minimum 1-year Commercial, HMO, PPO, and Workers Compensation billing and/or Insurance follow-up experience.
Working knowledge of HMO, PPO, Commercial, and Workers' Compensation reimbursement.
Working knowledge of Managed Care contract language and interpretation.

Responsibilities

Insurance follow-up, as assigned.
Contact insurance carriers regarding outstanding balances until resolution.
Resubmit claims with the appropriate remarks and/or attachments as needed.
File insurance reconsideration letter for payment and/or denial disputes.
Validate accounts for accurate payments, discounts, and contractual adjustments.
Reply to insurance carrier correspondence as appropriate.
Run insurance eligibility and correct claim before resubmission as needed.
Pull supporting documents for annual regulatory audits, as needed.
Ensure credit balance and refund requests are reviewed and resolved timely.
Answer in-coming calls resolving patient and/or insurance issues timely.
Assist with other duties as assigned, within skill sets and abilities.