Apply Description

SUMMARY

The Collection Specialist is responsible for patient and insurance accounts receivable, following up as needed to ensure collection of monies owed from all sources. Assumes responsibility and is accountable for adherence to WC policies and procedures, as well as all applicable federal and state laws as they pertain to healthcare and employment.

ESSENTIAL DUTIES

Develops relationships with patients providing counseling regarding their fiscal responsibilities in relationship to their care. Calls patients regarding past due balances, processes and reviews account adjustments, resolves client discrepancies and short payments. Reviews and processes patient and payer refunds.Reviews and processes financial assistance forms and makes appropriate payment arrangements based on patient ability to pay.Accountable for reducing delinquency for assigned accounts. Reviews and takes corrective action on denied and underpaid claims to collect revenue due in a timely manner.Reviews accounts and makes recommendations to physicians regarding next steps in collection activity.Reviews and processes mail returns and patient statements.Answers incoming business office phone calls. Assists other departments and patients with business office questions in a courteous and respectful manner.Responsible for protecting Personal Health Information (PHI) and maintaining compliance with WCs Privacy Policy. Uses the minimum PHI necessary when completing assignments.Promotes, establishes, and maintains open and effective communications with all members of WC.

SECONDARY DUTIES

Assumes responsibility for various department functions in the absence of staff members or in overload situations.Participates actively and helpfully in special committees as assigned by management and/or physicians.Completes assigned compliance and/or competency training.Any other duties as defined by management or physicians.

SUPERVISORY RESPONSIBILITY

This position does not supervise any employees.

Requirements

EDUCATION AND EXPERIENCE

Minimum of a High School Diploma and two years of related experience. Work related experience should be in the medical billing office environment with an emphasis on collections. Educational experience, through in-house training, formal school or related curriculum, should be applicable to medical billing and collections.

COMPETENCIES

Advanced knowledge of general medical terminology, CPT and diagnosis coding, medical insurance and managed care.Exceptional organizational and time management skills to ensure maximum productivity.Exceptional verbal, written, and interpersonal communication skills with the ability to apply common sense; to carry out instructions, write reports, correspondence, and speak clearly to patients, employees and owners.Ability to deal with complex problems involving multiple facets and variables in non-standardized situations.Ability to maintain confidentiality and handle sensitive information with discretion.Ability to work with little supervision while performing duties.

WORK ENVIRONMENT AND PHYSICAL DEMANDS

This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines.

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform essential duties.

Frequently required to talk, hear, and convey or exchange information in a clear and concise manner.Requires close visual acuity to perform an activity such as viewing a computer terminal; reading business periodicals, professional journals, and technical procedures; and analyzing data and figures.Frequently required to stand, walk, and/or move about the office to accomplish tasks.Frequently required bend, sit, stoop and stretch.Occasionally required push, pull, reach, and/or transport supplies and or equipment to various locations within the office. 10-50 pounds.Frequently uses arms, hands and fingers for grasping, pushing/pulling, twisting/turning of wrists, and manipulating in the performance of various clerical duties such as typing, writing, and maintaining files; and/or to operate technological equipment.Rarely required to have full range of body motion in order to assist, move, and/or lift patients. 75+ pounds.