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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.
Job Responsibility:
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
Requirements:
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