Under the direction of the Business Office Manager, the Collections Specialist is responsible for follow up on delinquent surgery center claims), working an expected number of claims per day. Majority of claims will have been submitted to various insurance carriers electronically. Knowledge of how to interpret a managed care contract, Medicare and Medicaid and Workers Compensation claims is a must. You will be given tools to calculate allowable and required to determine appropriateness of reimbursement and appeal claims as necessary. Extensive contact with insurance carriers of all types, as well as communication with patients regarding out of pocket amounts is required. Identification of accounts that have been either under or over paid, issuing credit balance information either to the insurance carrier or the patient. All of these practices done in a professional and communicative manner, per policies and procedures, guidelines, internal control measures and established goals. . Candidate must be a team player, and have ability to communicate well with direct reports, patients, customers, insurance carriers, etc. Ability to manage accounts worked independently, and in a productive manner. Must project a professional demeanor and appearance while maintaining the confidentiality of the surgery center and patients. Works well in stressful environment and in situations that demand patience. Projects a professional demeanor and appearance while maintaining the confidentiality of administration, patients, physicians and employees. Works under stress and in situations that demand patience and tact while providing impeccable service.
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
Job Type
Full-time
Industry
Hospitals
Education Level
High school or GED
Number of Employees
5,001-10,000 employees