Collections Specialist

QUALIFICATIONS:

•  High school diploma or GED required; Associate degree in Accounting, Business, or Healthcare Administration preferred.


• Minimum 1–2 years of experience in medical collections, healthcare billing, or a similar role in a hospital or clinic.


• Familiarity with EHR and billing systems (e.g., Epic, Cerner, Meditech) is highly desirable.


• Strong knowledge of insurance claims processes, CPT/ICD-10 coding basics, and third-party payer requirements.


• Excellent communication, negotiation, and problem-solving skills.


• Ability to manage multiple accounts and prioritize tasks in a fast-paced environment.

RESPONSIBILITES:

• Monitor and manage aged accounts receivable for both patient and insurance balances.


• Contact patients, insurance companies, and third-party payers to collect overdue balances via phone, email, or written correspondence.


• Review and resolve claim denials and underpayments, including filing appeals when necessary.


• Work closely with the billing team to ensure accurate claim submissions and resolve billing discrepancies.


• Educate patients on their balances, insurance coverage, and payment plan options.


• Document all collection activities and patient interactions in the hospital’s electronic health record (EHR) or billing system.


• Meet or exceed departmental productivity and collection goals.


• Stay updated on payer guidelines, insurance policies, and federal/state regulations (HIPAA,
  FDCPA, etc.).


• Maintain patient confidentiality and treat all individuals with respect and professionalism.


• Follow-up on accounts with outstanding balances that do not have appropriate payment
  arrangements.

PHYSICAL DEMANDS:

• Prolonged periods sitting at a desk and working on a computer.


• Occasional lifting of office supplies and files (up to 15 lbs.).