Medical Collections Specialist

JOB TITLE: Medical Collections Specialist  

EMPLOYER: Twelfth One, LLC, dba Aspen Infusion

DEPARTMENT: Billing

REPORTS TO: Director of Revenue Cycle

SUMMARY: The Medical Collection Specialist is responsible for ensuring the timely submission of electronic and/or paper claims, monitoring claim status, researching rejections and denials, documenting related account activities, posting adjustments, payer projects, and other duties assigned.

DUTIES AND RESPONSIBILITIES:

• Submit written appeals to payers to overcome denials
• Follow-up with the payer to facilitate uninterrupted cash flow
• Answer questions from customers and payers. 
• Adhere to all practice policies related to HIPAA and Medicare Compliance.
• Provide feedback to management regarding account issues. 
• Contribute to the objectives and outcomes as directed.
• Collect delinquent accounts by establishing payment arrangements with patients that include monitoring payments and following up with payments when lapses occur
• Help manage the A/R by performing all aspects of the account follow-up on self-pay accounts or accounts with patient liability to ensure timely collection of assignments to the collection agency
• Assist in the processing of insurance claims including working the denials from the clearing house
• Analyzing and researching denials
• Follows Best Practices regarding initial follow-up/first contact at 21- 28 days for insurance claims and subsequent follow-up every 10-14 days

SUPERVISORY RESPONSIBILITIES:

• This position has no supervisory responsibilities.

QUALIFICATIONS:

• High school diploma or general education degree (GED), or one to three months related experience and/or training, or equivalent combination of education and experience.
• Knowledge of home infusion billing/coding and CareTend software preferred
• Computer skills required: Microsoft Office Suite, Google Suite, spreadsheets, use of Internet and Email
• Perform follow-up activities in a timely manner on all accounts to ensure prompt payments.
• Minimum (2) years of experience in a medical office setting.
• Knowledge of Medicare, Medicaid, and Commercial payer collections. 

COMPETENCIES:

• Ethics - Treats people with respect; Keeps commitments; Inspires the trust of others; Works with integrity and ethics; Upholds organizational values.
• Attendance/Punctuality - Is consistently at work and on time; Ensures work responsibilities are covered when absent; Arrives at meetings and appointments on time.
• Customer Service - Manages difficult or emotional customer situations; Responds promptly to customer needs; Solicits customer feedback to improve service; Responds to requests for service and assistance; Meets commitments.
• Quality - Demonstrates accuracy and thoroughness; Looks for ways to improve and promote quality; Applies feedback to improve performance; Monitors own work to ensure quality.

PHYSICAL DEMANDS AND WORK ENVIRONMENT:

• Continually required to stand, walk, sit, talk, or hear.
• Continually required to utilize hand and finger dexterity
• Continually utilize visual acuity to operate equipment, read 
• technical information, and/or use a keyboard
• Occasionally required to lift/push/carry items less than 30 pounds 
• Occasional exposure to bloodborne and airborne pathogens or infectious materials

The above is intended to describe the general content of and requirements for the performance of this job. It is not to be construed as an exhaustive statement of duties, responsibilities or physical requirements. Nothing in this job description restricts management’s right to assign or reassign duties and responsibilities to this job at any time. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.