The Medical Collections Specialist achieves timely collection (payment) of outstanding hospital claim balances related to claim underpayments or denials. Collections may be related to appeals or grievances filed with health insurance plans/payors, corrected claims, assigned account balances, or other payment barriers. The position is responsible for the timely and complete collection of outstanding hospital insurance balances. This is achieved by following appropriate guidelines for billing, coding, collection, payment posting and customer service. Collection is achieved through follow up and coordination with individual insurance plans and their provider appeals and grievances departments.
To perform this job successfully an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Education · High School Diploma or equivalent.
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Physical Activities - While performing the duties of this job, the employee is regularly required to reach with hands and arms and talk or hear. The employee is frequently required to sit. The employee is occasionally required to stand and walk.
Weight Lifted/Force Exerted - Lifting of minimal weight (<20lbs) may be occasionally required. Assistance can be provided as necessary.
Vision Requirements - Specific vision abilities required by this job include close vision and the ability to adjust focus.
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Environment Conditions - While performing the duties of this job, the employee does not work in wet or humid conditions (non-weather), work near moving mechanical parts, work in high, precarious places, endure outdoor weather conditions, endure extreme cold or heat (non-weather), or is at risk of electrical shock.
Noise Level - The noise level in the employee's work environment is usually quiet to moderate.