Medical Collections Specialist

hace 2 semanas


Tijuana, México USA Clinics Group A tiempo completo

We are seeking an experienced and highly detailed **Medical Collections Specialist** to join our Revenue team. The Medical Collections Specialist is the primary source for managing patients' delinquent accounts including sending accounts to collections. This position will hold the responsibility of arranging repayment agreements with the patient and assisting in other parts of the billing office as needed.

**Duties and Responsibilities**:

- Explain Benefits to Patients
- Contact Patients regarding outstanding co-payments and deductibles
- Process Patient and/or Insurance Refund Requests
- Submit Appeals for Denied Claims
- Send Medical Records and other documentation requests to insurance (as needed)
- Review EOBs and Post Payments
- Review/Monitor Reports (Pending Charges, A/R, Medical Records & Tasks)
- Research & Resolve Outstanding Claim issues
- Works with report management system.
- Checks benefits through InstaMed, Navinet, MassHealth or any other website that check benefits and eligibility.
- Uses the organization’s EMR system proficiently.
- Uses EMR’s Eligibility tool to see if insurance is active.
- Follows the routine protocol of further task creation for all departments in case of approval or denial.
- Uses Excel proficiently.
- Demonstrates knowledge of services, professionalism and outstanding customer service.*
- Handles multi-line and multi-language telephone calls.*
- Demonstrates knowledge of services, professionalism and outstanding customer service.*
- Adheres to established procedures for inter-office communication and other guidelines related to the job and the company.*
- Performs other related duties as assigned.

**Requirements**:

- Expert knowledge of Microsoft Office (Outlook, Excel and Word).
- 1+ years of Collections or relevant experience required
- Effective Communication skills, ability to work in a high volume patient environment, results and goal oriented, ability to set priorities and meet deadlines, strong attention to detail, self starter, and Service Excellence skills.
- Ability to multi-task effectively.
- Quality improvement philosophy with high level of job accuracy, efficiency and dependability.
- Maintain 100% confidentiality relating to all patients, corporate, financial and proprietary information.



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