COLLECTION SPECIALIST - ADVANCED DALLAS HOSPITAL AND CLINICS

Job Details

Job Location
Advanced Diagnostics Dallas Hospital Clinics - Dallas, TX

Position Type
Full Time

Education Level
High School Diploma/GED

Job Shift
Day

Job Category
Administrative/Support

Description

JOB SUMMARY

The Collections Specialist is responsible for handling billing issues and making outbound collection calls to resolve patient accounts. To succeed in this role, you must possess in-depth knowledge of Out of Network collections practices and insurance policies. The ideal candidate must also be able to demonstrate excellent written and verbal communication skills, as communicating with various insurance companies, plan administrators, team members and customers.

This position requires a driven individual that can multi-task, problem solve, and manage workload and time effectively.

This involves performing collection activities related to follow-up and account resolution, and includes communication to patients, clients, reimbursement vendors, and other external entities while adhering to all guidelines. Patient and client satisfaction is essential.

DUTIES AND RESPONSIBILITIES
Possesses thorough understanding of the hospital revenue cycle with specialization in hospital billing, follow-up, and the account resolution process.
Utilize and apply industry knowledge to resolve aged accounts receivable by working various account types including, but not limited to: hospital and/or professional claims, governmental and/or non-governmental claims, denied claims, high priority accounts, etc.
Communicates with patients to help them resolve their healthcare accounts.
Receives and properly handles incoming phone calls by assisting patients with their questions or concerns, arranging payment arrangements, and obtaining insurance information from patients.
Collects and processes payments over phone.
Makes outbound calls in an effort to resolve the patient account.
Document all collections activity performed on each account in the system.
Reviews general accounts receivable incoming correspondence and takes timely and appropriate action.
Analyzes account for errors, adjustment, credits, issuing corrected entries when required. Escalates complex issues. Updates account information.
Manage multiple work queues for follow-up and denials by engaging payor websites and initiate calls to ensure prompt payment of medical claims. Pursues and/or follow-up on appeals. Initiate communication with coding team and clinical staff when coding related, and medical necessity appeals are warranted.
Identify denial trends and notify Supervisor and/or Manager to prevent future denials and further delay in payments. Makes recommendations for resolution.
Maintains positive working relationships and fosters a cooperative work environment. Adheres to the hospital's compliance program.

Qualifications

REQUIREMENTS
High school diploma or GED.
Some College, Associate's Degree or higher preferred.
Minimum two years' medical office experience.
One year of relevant experience in Acute Care setting.
10yrs Experience with collections in healthcare revenue space is preferred.
Multi-Specialty insurance experience.
Desktop applications to include Word and Excel are essential.
Epic, Athena, or similar software experience highly desired.

EDUCATION
High School Diploma or GED
Some College, Associates, or Bachelor's preferred.

CERTIFICATION, LICENSURE

KNOWLEDGE SKILLS & ABILITIES
Extremely conscientious with excellent organizational skills.
Capable of working independently and as a team member.
Must be very customer service oriented.
Broad knowledge of the content, intent, and application of HIPAA, federal and state regulations
Knowledge with in and out of network insurances, insurance verification, patient responsibility, and process for prior authorization.
Ability to stay focused in a fast-paced environment, manage time efficiently, and able to multitask.

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