Collections Specialist I - Account Integrity
About The Position
The Collections Specialist I - Account Integrity is responsible for performing collection follow-up on outstanding insurance balances, identifying claim issues, and ensuring timely resolution in compliance with government and managed care contract terms. This role requires effective communication with insurance payers, documentation of account activity, and adherence to applicable regulations to support revenue cycle operations. The Shared Services Center - Nashville provides business office support functions like billing, insurance follow-up, call center customer service, data entry and more for hospitals and healthcare providers. Community Health Systems is one of the nation's leading healthcare providers, operating 69 affiliated hospitals with more than 10,000 beds and approximately 1,000 other sites of care across 36 distinct markets in 14 states.
Requirements
- H.S. Diploma or GED required
- 0-2 years of experience in medical collections, accounts receivable, billing, or healthcare revenue cycle operations required
- Strong understanding of medical collections processes, payer reimbursement policies, and insurance claim resolution.
- Proficiency in electronic medical record (EMR) systems, patient accounting systems, and collections software.
- Knowledge of insurance contracts, denials management, and accounts receivable workflows.
- Excellent problem-solving and analytical skills to research and resolve outstanding claims.
- Effective verbal and written communication skills to interact with insurance payers, patients, and internal teams.
- Strong attention to detail with the ability to document account activity accurately.
- Ability to work independently in a fast-paced environment while meeting productivity and quality standards.
- Knowledge of regulatory compliance, including HIPAA, FDCPA, and applicable healthcare finance laws.
Nice To Haves
- Associate Degree in Business, Finance, Healthcare Administration, or a related field preferred
- Experience working with insurance follow-up, claim resolution, and payer communication in a healthcare setting preferred
Responsibilities
- Performs follow-up on outstanding insurance balances within the required timeframe, obtaining payment confirmation or required documentation.
- Documents all actions taken on accounts within the appropriate system, ensuring a clear and traceable resolution process.
- Makes the required number of outbound calls to insurance payers while maintaining professional and courteous communication.
- Handles and resolves incoming correspondence within five days of receipt, updating the system with relevant information.
- Analyzes assigned accounts using AS400, Meditech, Accurint, Cerner, directory assistance, and credit reports to maximize collection efforts.
- Processes inbound and outbound calls professionally, providing exceptional customer service while resolving outstanding balances.
- Ensures proper application of account dispositions and follows self-pay policies and procedures.
- Adheres to all local, state, and federal laws and regulations, including FDCPA, TCPA, FCRA, CFPB, PCI, UDAAP, and HIPAA compliance standards.
- Performs other duties as assigned.
- Maintains regular and reliable attendance.
- Complies with all policies and standards.
Benefits
- Comprehensive Health Coverage – Medical, dental, and vision plans to keep you and your family healthy.
- Future Security: 401(k) with matching
- Student Loan Support – Up to $10,000 repayment assistance, because we invest in your future.
- Educational Tuition Assistance
- Competitive Pay & Full Benefits – A salary and package designed to reward your expertise and dedication.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
Number of Employees
5,001-10,000 employees
