Medical Collections Specialist

You, as the Medical Collections Specialist will perform designated billing and collection activities for assigned agencies to ensure receivables are reimbursed in an accurate and timely manner. You’ll also be working directly with the payer and internal and external customers towards efficient and effective collection results.

•Ensures the coordination of billing and collection activities for designated agencies, leading to the timely reimbursement of receivables using available resources including databases, internet, and telephone.

•Researches and identifies root cause of denials/rejections received daily, which have not passed payer edits. May utilize various agency/vendor systems and payer websites.

•Determines and initiates action to resolve denied/rejected invoices and prepares payer corrections and/or appeals using electronic and paper processes.

•Communicates with agencies to educate them concerning the importance of clean claims.

•Analyzes and clears payment variances. May prepare adjusted and corrected bills, adjust accounts receivable entries, or prepare refunds in accordance with existing operating procedures.

•Obtains appropriate clinical documentation and billing information to substantiate services provided and provide copies of documentation to payers as requested.

•Provides input on accounts receivable plans and process improvement, assisting in their implementation.

•Prepares special handling and/or reconciliation spreadsheets for payers and/or clients.

•Adheres to and participates in Company’s mandatory HIPAA privacy program / practices and Business Ethics and Compliance programs / practices.

•HS Diploma or GED

•2+ years’ Collections experience – Commercial Insurance, Medicare or Medicaid

•Experience with the following systems is preferred – AllScript, McKesson, Cerner, Soneto

•Excel knowledge

Are you an experienced Medical Collections and Billing Representative with Medicare and/or Commercial Insurance experience looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career by joining an outstanding organization? If you answered “yes" to any of these questions – this is the position for you!

If you are interested, reach out to me at 407-478-0332 ext 116.

The greatest compliment to our business is a referral. If you know of someone looking for a new opportunity, please pass along my contact information!