Collections (Payor) Specialist develops and implements effective collections strategies to reduce accounts receivable aging and improve cash flow using collection software and tools.
Key responsibilities include managing accounts receivable for insurers and payers, reviewing medical billing and coding documentation for accuracy and compliance, monitoring payer contract adherence, resubmitting and following up on claims, maintaining payer and patient communication, verifying insurance eligibility and coverage, and ensuring compliance with healthcare privacy laws such as HIPAA.
Requires 3-5 years experience in medical billing and collections in healthcare, proficiency with medical billing software and EHR systems, knowledge of medical terminology, CPT/HCPCS codes, insurance billing procedures, and healthcare compliance regulations including HIPAA, Medicare, and Medicaid.
Education: High school diploma or equivalent required; certification in medical billing and coding preferred (e.g., CPC).
Physical requirements include ability to remain stationary and operate office machinery.
- Minimum 3-5 years experience in medical billing and collections, preferably healthcare setting
- Proficient in medical billing software and electronic health records systems
- Strong understanding of medical terminology, CPT/HCPCS codes, and insurance billing procedures
- Excellent verbal and written communication skills
- Detail-oriented and accurate in data entry and documentation
- Ability to work independently and collaboratively in fast-paced environment
- Knowledge of healthcare compliance regulations including HIPAA, Medicare, Medicaid
- High school diploma or equivalent
- Certification in medical billing and coding preferred (e.g., CPC)
Location
Pennsylvania, US
Employment Type
Full-time
Experience Level
Intermediate Level
Remote work allowed
No
Posted
2 weeks ago