Excellent written and verbal communication skills.
Excellent knowledge of insurance carrier billing and reimbursement, including medical terminology, International Classification of Diseases, Ninth and Tenth Revisions, and Current Procedural Terminology/Healthcare Common Procedure Coding System codes.
Ability to type at least 60 words per minute and use a 10-key keypad by touch.
In-depth understanding of Explanation of Benefits statements and at least one year of prior medical collections experience in a medical office, central business office, or hospital business office setting.
Detailed working knowledge and demonstrated proficiency in at least one insurance company's billing or collection process.
Experience with patient accounting systems and ability to research medical coding.
High School Diploma or GED.
At least two years of experience in a high-paced collections environment.
Strong math skills.
Ability to maintain strict patient confidentiality.
Willingness to work overtime as needed to meet business objectives.
Responsibilities
Initiate collection follow-ups for all unpaid or denied claims with the appropriate payer.
Research, appeal, and resolve claim rejections, underpayments, and denials with the appropriate payer.
Respond to written payer communications with the appropriate action in a timely manner.
Process claims and appeals by gathering information for appeals.
Request insurance changes through the billing system as required during the collections process.
Communicate payment or denial patterns that impact revenue to management in a timely manner.
Maintain communication and document daily in the billing system all follow-up and communication on patient accounts in a consistent and concise format.
Develop and maintain positive working relationships with team members and payer representatives.
Represent clients professionally while prioritizing customer satisfaction.
Perform work in a home-office environment and operate required office equipment.
Position: Collections Specialist Location: Houston, TX - Work from home ** MUST BE LOCAL **
Position Goals This is the job description for the Collections Specialist position for Specialty Healthcare Billing and Consulting (SHB&C) and additionally provides criteria for the evaluation of the position. The Collections Specialist position plays a critical part in the medical billing process. Under the supervision of the Facility Collections Director, the Collections Specialist is responsible for the timely collection of unpaid claims including appeal denials, collections of underpayments, and documenting all collection activities in the billing system. The Collections Specialist will meet or exceed the daily and monthly productivity and performance goals set forth by the Collections Director. Additionally, the Collections specialist will have excellent customer service skills and have the ability to communicate effectively both written and verbally.
Position Responsibilities Under the direction of the Facility Collections Director, the Collections Specialist for Specialty Healthcare Billing & Consulting will be responsible for, but not limited to:
1. Initiating collection follow‐ups of all unpaid or denied claims with the appropriate Payer 2. Researching, appealing, and resolving claim rejections, underpayments, and denials with appropriate Payer 3. Responding to written Payer communications as indicated with appropriate action in a timely manner 4. Processing claims and appeals by gathering information for appeals 5. Requesting insurance changes through the billing system as required during the collections process 6. Communicating payment or denial patterns that impact revenue to management in a timely manner 7. Maintaining communication and documenting daily in the billing system all follow up and communication on a patient account in a consistent and concise format 8. Developing and maintaining positive working relationships with team members and Payer representatives 9. Maintaining the strictest patient confidentiality
Position Requirements The requirements for employment as the Collections Specialist for Specialty Healthcare Billing & Consulting are:
1. Excellent communication skillset; both written and verbal 2. Must have excellent knowledge of insurance carrier billing and reimbursement with knowledge of medical terminology, ICD‐9/ ICD‐10, and CPT/HCPCS codes 3. Must be able to type 60 wpm and be able to use 10‐key by touch 4. Must have an in‐depth understanding of the Explanation of Benefits (EOBs) with at least one year of prior medical collections experience in a Medical office, Central Business Office, or a Hospital Business Office etting 5. Detailed working knowledge and a demonstrated proficiency in at least one insurance company’s billing and/or collection process 6. Experience with Patient Accounting systems (s) as well as having the ability to research medical coding 7. Representing clients in a professional manner at all times ensuring customer satisfaction is a priority
Education/Experience
High School Diploma or GED – required 2 years of experience in a high‐paced, collections environment – minimum Strong math skills – required
Physical Demands 1. Requires some bending, stooping, stretching 2. Requires eye‐hand coordination and manual dexterity sufficient to operate a keyboard, photocopier, telephone, calculator, and other office equipment 3. Requires normal range of hearing and eyesight to record, prepare, and communicate appropriate reports 4. Requires lifting papers or boxes up to 50 pounds occasionally 5. Requires dexterity to type 60 wpm or more 6. Work is performed in a home-office environment 7. Work may be stressful at times; high‐pressured, fast‐paced environment with significant telephone and personal disruption 8. Must be willing to work overtime as needed to meet business objectives
Compensation and Benefits
SHB&C offers competitive hourly pay
401k with Match for all employees
Medical, Dental, and Vision for Full-Time Employees
Paid Time Off for Full-Time Employees
Remote - Work from home
Job description statements are intended to describe the general nature and level of work being performed by employees assigned to this job title. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required.
Company is an equal opportunity employer inclusive of female, minority, disability and veterans, (M/F/D/V). Hiring, promotion, transfer, compensation, benefits, discipline, termination and all other employment decisions are made without regard to race, color, religion, sex, sexual orientation, gender identity, age, disability, national origin, citizenship/immigration status, veteran status or any other protected status.