Negotiations Specialist

Alliance Health System•Matawan, NJ

19h•Remote

About The Position

The Revenue Cycle Management Negotiations Specialist works in a clinical back-office setting to support timely collection of outstanding payments from patients, insurance companies, and other third-party payers. The role manages negotiated claims and collection activities, helps maximize revenue realization, and contributes to the organization’s financial stability. The position is remote and reports to the Director of RCM.

Requirements

High school diploma or equivalent.
Proven work experience as a Collections Specialist in a healthcare or clinical back-office setting, with a focus on revenue cycle management.
In-depth knowledge of medical billing and coding processes, insurance claim submission, and reimbursement procedures.
Familiarity with insurance industry regulations, billing guidelines, and compliance requirements, including HIPAA.
Proficiency with revenue cycle management software and tools for managing collections, tracking accounts, and generating reports.
Strong understanding of healthcare reimbursement methodologies, including commercial insurance, Medicare, and Medicaid.
Excellent communication and negotiation skills, with the ability to interact professionally and empathetically with patients, insurance companies, and other stakeholders.
Detail-oriented approach and ability to review and analyze complex billing statements, claims, and denials.
Strong problem-solving skills, including the ability to identify billing discrepancies, resolve disputes, and address payment challenges.
Ability to work independently, manage multiple priorities, and meet deadlines in a fast-paced clinical back-office environment.

Nice To Haves

Associate's or bachelor's degree in healthcare administration or a related field.

Responsibilities

Manage collections for negotiated claims, following up on unpaid claims, invoices, and patient balances.
Use revenue cycle management software and tools to track and prioritize collection activities and ensure timely, accurate follow-up.
Review unpaid claims and denials, identify root causes, and take appropriate action to resolve them.
Contact patients, insurance companies, and other payers to discuss balances, resolve billing discrepancies, and negotiate payment arrangements.
Maintain accurate records of collection efforts, communications, and payment arrangements in compliance with legal and organizational requirements.
Collaborate with billing and coding teams to support accurate and timely submission of claims and invoices.
Stay current on insurance regulations, billing guidelines, and reimbursement policies to maximize collections and minimize denials.
Help patients understand their insurance coverage and billing statements, and address their financial concerns.
Work with the finance department to reconcile payments, identify posting errors, and ensure accurate accounting of collections.
Generate reports and provide regular updates on collection metrics, aging accounts, and potential revenue risks to the revenue cycle management team.