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Collections Specialist

Oceans Healthcare

The Collector is responsible for accurate and timely billing and collection of outstanding receivables from third-party payers and payer representatives. The role maintains accurate account balances in accordance with contractual obligations, fee schedules, and applicable regulations.

  • Reviews third-party claims for accuracy and completeness using patient accounting functionality
  • Submits claims to third-party payers within timely filing restrictions
  • Performs follow-up by telephone or electronic inquiry on accounts with outstanding third-party payer balances
  • Resolves issues that may delay claim processing and involves the patient/guarantor as necessary
  • Documents follow-up activity in the patient accounting system
  • Resubmits claims as needed, including secondary and tertiary claims
  • Ensures accurate account balances and requests contractual allowances, adjustments, and balance transfers as necessary
  • Communicates with revenue cycle staff, Utilization Review/Case Management, and site leadership to support timely claim payment
  • Researches and resolves credit balance accounts
  • Completes daily and weekly productivity and performance reporting
  • Performs other duties and projects as assigned

The work environment may involve frequent interruptions, multiple calls and inquiries, and a high-paced, stressful setting.

Requirements & Qualifications

Educational / Experience Requirements

  • High school diploma or equivalent required
  • Previous experience interpreting insurance plan benefits, conditions of payment, and billing requirements preferred
  • Previous customer service experience in a similar field is beneficial

Qualifications / Skills

  • Experience with Microsoft Office products and general patient accounting systems
  • Knowledge of third-party payers, Medicare, Medicaid, and other payer requirements
  • Strong communication skills for phone contact with insurance payers
  • Customer service skills for interacting with patients and family members regarding medical claims and payments
  • Ability to work in a team environment
  • Ability to function with minimal supervision and maintain confidentiality
  • Understanding of applicable state and federal laws and regulatory requirements

Location

Louisiana, US

Employment Type

Full-time

Experience Level

Entry Level

Remote work allowed

No

Posted

1 month ago

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