COMMERCIAL BILLING & COLLECTIONS SPECALIST

Guardian Recovery•Delray Beach, FL

9h•$18 - $23•Onsite

About The Position

The Commercial Billing and Collection Specialist is responsible for the timely generation of claims and collections of outstanding accounts receivable dollars from the existing client base and all other aspects of collections, resolving insurance billing problems and reducing accounts receivable delinquency as they relate to recent rejections or failure to pay within thirty (30) through sixty (60) calendar days.

Requirements

Bachelor's degree (B.A./B.S.) from four-year college or university; or two to four years related experience and/or training; or equivalent combination of education and experience. Minimum of high school diploma or equivalent required.
Minimum of 2 years’ experience in medical billing and coding
Knowledge of the Principles and Practices of the discipline.
Knowledge of Joint Commission Standards.
Demonstrates Proficiency in Communication & Written skills.
Knowledge of State & Federal Statutes Regarding Client Confidentiality laws.
Knowledge of Drug-Free Workplace Policies.
Knowledge of Workplace Violence
Strong communication skills, problem solving and working knowledge of insurance payment methodologies.
Attention to detail with an eye for accuracy.
Excellent written and verbal communication skills
Knowledge in reading, analyzing, and interpreting common scientific and technical journals, financial reports, and legal documents.
Effective in presenting information to top management, public groups, and/or boards of directors.
Knowledge in writing professional emails, formal letters, speeches, and articles for publication that conform to prescribed style and format.
Knowledge in calculating figures and amounts such as discounts, interest, commissions, proportions, percentages, area, circumference, and volume. A
Knowledge in applying concepts of basic algebra and geometry.
Creative, self-disciplined and capable of identifying and completing critical tasks independently and with a sense of urgency.
Ability to prioritize and manage multiple responsibilities.
Proficient in using Microsoft Office Products

Responsibilities

Submit insurance claims via electronic clearinghouse and paper claims via mail.
Perform audits of assigned accounts before submitting claims to ensure accuracy and validity.
Provide continual follow-up within the billing software to ensure claims are received by insurance companies appropriately.
Review claim holds and facilitates clean claim processing.
Work within the department and with the other departments to ensure precise submission of claims.
Ensure client demographics are correctly entered in the billing software.
Participate in companywide and departmental meetings.
Commits to providing excellent customer service while maintaining the highest degree of professionalism while working in a team environment to meet goals.
Adhere to all company policies and procedures.
Review all open claims for collection efforts needed.
Review and effectively troubleshoot all known denials and rejections through correspondence or telecommunication.
Make outbound collection calls to commercial payers in a professional manner.
Resolve insurance related problems and reduce accounts receivable delinquency, applying professional customer service skills in a timely manner.
Make demands on insurance due payments in accordance with payment due dates, state and federal regulations.
Identify issues attributing to account delinquency and non-payment and discuss them with the direct manager.
Review and monitor assigned accounts and all applicable collection reports, and other insurance due related duties as assigned.
Provide timely follow-up on payment guarantees and claims rebilled for payment.
Mail correspondence to customers/insurers to encourage payment of delinquent accounts and make certain scans of all outgoing demands are made.
Fax documents, medical records, authorizations, or other requested information (within reason) to insurers and perform follow-up as required to maintain company standards.
Protect the privacy of all client information in accordance with GRNH, LLC’s privacy policies, procedures, and practices, as required by federal and state law, and in accordance with general principle of professionalism as a healthcare provider. Failure to comply with the company’s policies and procedures on client privacy may result in disciplinary action up to and including termination of employment.
May access protected health information (PHI) and other patent information only to the extent that it is necessary to complete your job duties. The incumbent may only share such information with those who have specific client information you have in your possession to complete their job responsibilities related to treatment, payment or other GRNH, LLC operations.
Expected to report, without the threat of retaliation, any concerns regarding GRNH, LLC’s policies and procedures on client privacy and any observed practices in violation of the policy to their supervisor.
Perform other duties as assigned.