Medical Collections Specialist, Full-Time (Hybrid)

Surgery Partners, Inc•Addison, TX

3d•Hybrid

About The Position

The primary responsibility of the Medical Collection Specialist is to ensure effective collection of all patient accounts. This is a hybrid/remote position requiring internet speed of 5MB upload and 5MB download.

Requirements

High School Diploma
3 to 5 years previous experience in office billing and collections environment (CBO)
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 which includes Outlook, Word, Excel, and Power Point
Critical thinking skills
Minimum of three years’ experience in medical collections

Nice To Haves

Spine/Orthopedic surgery experience preferred
EPIC experience preferred
Hospital Billing/Collections preferred

Responsibilities

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
Understanding of copays, coinsurance, deductibles, and denial codes
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
Maintains a positive attitude toward their position and responsibilities