Collections Specialist

Community Options, Inc.•Princeton, NJ

1d•Onsite

About The Position

Community Options, Inc. is a national non-profit agency providing services to individuals with disabilities in 12 states. We are actively seeking a Collections Specialist in Princeton, NJ to support our finance team and ensure the financial health of our Medicaid programs. The Collections Specialist will play a vital role in ensuring timely payments, maintaining accurate financial records, and collaborating with the local offices and Medicaid entities to resolve outstanding balances. This role will report to the Collections Manager and will work hand in hand with the manager to ensure the financial health of all Medicaid programs for the organization. This is an onsite opportunity.

Requirements

At least two years’ experience, preferably with a background in admissions, social services, administration, and/or public relations
High school diploma or equivalent, Bachelor’s or associate degree preferred
Familiarity with Social Security and Medicaid
Knowledge and understanding of local and regional regulatory operations
Knowledge and understanding of state regulations
Experience with intake and admissions
Working Knowledge of ICD-10 codes
Therap experience is a plus
Proficiency in Microsoft Outlook, Word, and Excel
Employment is contingent upon successful completion of checks of criminal background, central registry, child abuse registry, and drug testing

Nice To Haves

Therap experience is a plus

Responsibilities

Ensure that the organization receives all necessary payments at the correct, and contracted rate from each consumer insurance company
Review insurance carriers’ denial reports, remittances, and correspondence to find issues preventing payment
Analyze accounts receivables and collections data, in search of trends and patterns to improve billing, collections, and DSO results
Resolve consumer insurance balances by analyzing denials and using critical thinking skills and knowledge of payor requirements to determine the steps needed to obtain payment
Based on payer processes, utilize payer portals, paper/electronic remits and/or place calls to the payer to understand and resolve denials
Review data on insurance authorizations to ensure accurate claim processing and payment
Work accounts holistically, building on the last intervention and not repeating tasks
Complete projects assigned for specific payers or specific types of accounts, ensuring deadlines are met
Strive to achieve and maintain company Days Sales Outstanding and Account Receivable aging standards
Create a tickler file to ensure timely follow-up of outstanding claims/balances consistent with the timely filing limits of the payors
Develop and submit appeals, including supporting documentation as needed
Prepare a weekly report with status updates and communication taken on problem accounts
Ability to manage daily job functions along with special project work and prioritize the level of importance on demand
Uphold the strictest confidentiality and adhere to all HIPAA guidelines/regulations
Keep accurate and thorough records of all communications and follow-up relating to the accounts that the position is responsible for
Perform other duties as assigned by management.