POSITION SUMMARY: Our Healthcare organization is seeking experience Third Party Collections Specialist to join our team. The ideal candidates will have a strong background in Third Party Collections the position will report directly to the team lead and the Manager of Third Party Collections. Position is 90% remote after in-office training subjected to change based on business needs.

 

ESSENTIAL FUNCTIONS

Performs all functions according to established policies, procedures, regulatory and accreditation requirements, as well as applicable professional standards. Provides all internal and external customers of Physicians Immediate Care with an excellent service experience by consistently (1) supporting the Company’s goals and mission, (2) following all Company policies and procedures, (3) providing quality customer service, and (4) following safety standards in performing all aspects of the functions below.

 

  • Medical Collections: Utilize A/R reports/system work lists to identify accounts that are past timely payment. Contact insurance company, vendor or patient to learn status of outstanding claim
  • Appeals: Write appeals to insurance companies to overturn denied or short paid claims
  • Medical Billing: Re-bill claims that are not on file at the insurance company or third party vendor and provide substantiating documentation if necessary
  • Documentation: Obtain necessary documentation (updated medical order, clinical notes, patient agreement, etc.) and submit to insurance carrier
  • Patient/Provider: Contact patient, provider, to relay and/or obtain pertinent information and/or documents to assist in the collection of claims
  • Research and resolve incorrect payments
  • Answer patient inquires by phone regarding outstanding account balances and insurance guidelines
  • Contact responsible party to resolve delinquent accounts
  • Post adjustment entries
  • Identify and prepare insurance refunds
  • Performs other duties as assigned
  • Ensure that all information regarding collection activity of account is entered accurately into the billing system
  • Bring recurring issues /trends to the attention of the department manager

 

 QUALIFICATIONS

  • High School Diploma or equivalent required
  • Minimum 3-5 years of experience in medical collections and understanding of HCFA-1500 claim forms and re-billing process
  • Experience working with all payer types to include Medicare, Medicaid, and third party commercial insurance companies
  • Strong analytical skills
  • Excellent phone skills
  • Computer Savvy
  • Quick learner
  • Ability to handle multiple tasks simultaneously under strict deadlines
  • Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations

At Physicians Immediate Care you will enjoy full benefits including a generous wellness plan, a company matched 401K plan, a Monday through Friday schedule with a great work-life balance. Come join our team!

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