Regional Collection Specialist

PDS Health•Irving, TX

About The Position

The Regional Collection Specialist assists with collections and coaches and trains Operation Managers (OMs) on the Aging Collection Report to help ensure claims are properly billed to patients and insurance companies and ultimately paid. The role partners with the Central Billing Office (CBO) and works proactively to ensure insurance companies are billed correctly and promptly and receivables are collected effectively in each office.

Requirements

High school diploma or GED, or equivalent, required.
3–4 years of related experience in the dental field, required.

Nice To Haves

Bachelor's degree and 3 to 5 years of related experience.
Prior experience as a claims auditor within a group practice environment.
QSI (Quality Systems Inc.) experience.

Responsibilities

Check relevant portals weekly, including Request for Information (RI), Credit, and Claims, to obtain missing information and take necessary action on credit goals and past-due adjustment requests from CBO.
Process the Aging Collection Report, ensuring complete accounts are properly billed to patients and insurance, and review accounts in their entirety rather than only a point-in-time date of service.
Read and analyze Explanation of Benefits (EOB) statements and adjust accounts according to PDS claims processing criteria, including claim tracing, contacting insurance carriers, and ensuring patient balances are secured as appropriate.
Document all account actions in the system and maintain ongoing communication with CBO about handled accounts.
Provide ongoing one-on-one or group coaching and training to OMs and Benefit Coordinators (BCs).
Meet monthly with OMs in the assigned region to work through credit and collection reports and increase office collection rates.
Communicate trends and process-improvement suggestions to OMs, Regional Managers (RMs), Regional Partners (RPs), and CBO.
Meet with the RM at month-end to review accounts sent to collections over Company approval limits and claim adjustments outside Company policies.
Develop systematic approaches to process improvement and coordinate and communicate changes and enhancements.
Participate in CBO operations calls and other required meetings.
Ensure compliance with Company policies and applicable State, Federal, and other regulatory requirements.
Maintain a professional appearance and demeanor in accordance with Company policy.
Perform other duties as assigned by management.