31 Oct
Credit Specialist - Healthcare Collections Experience Preferred
Florida, Lakemary , 32746 Lakemary USA

Vacancy expired!

Job Description

Position Summary:

Perform duties to process medical billing and credit collections with focus on accuracy timeliness and adherence to process. Reduce DSO, recognize additional revenue opportunities, and improve in credit collection rates, while working within the limits of standard or accepted practice.

Essential Functions:

  • Review patient files for completeness and accuracy, identify and audit claims, ensure all revenue opportunities are included.
  • Review documents received including Explanations of Benefits (EOBs), Remittance Advices (RAs) and other documents indicating credit balances. Identify reasons for credits, take required corrective action, and take ownership of claims through to timely, successful resolution.
  • Analyze credits, identify trends and recommend process improvement opportunities that will result in credit DSO reduction, superior credit rate and intervals and simplified processes that are responsive to the requirements of specific payers.
  • Review claims with outstanding credit balances and identify actions to successfully resolve. Follow up with insurers and patients to resolve outstanding balances in an environment of excellent customer service focused on building enduring customer and business relationships.
  • Document case activity, communications and correspondence in computer system to ensure completeness and accuracy of account activity and actions taken to resolve outstanding claims issues.
  • Contribute medical claims expertise to the design of training and knowledge transfer programs, materials, policies and procedures to improve the efficiency and effectiveness of the Revenue Cycle Management team.

Other Duties:

  • Perform or assist with any departmental projects or operations, as required to maintain workflow and to meet schedules and quality requirements.
  • Participate in any variety of meetings and work groups to integrate activities, communicate issues, obtain approvals, resolve problems and maintain specified level of knowledge pertaining to new developments, requirements, and policies.
  • Perform other related duties as assigned.

Qualifications

Competency:

  • Demonstrated excellence in attention to detail and the ability to successfully manage multiple priorities with critical focus on accuracy.
  • Highly effective communicator with superior listening, understanding, speaking and writing while influencing patients, care givers, payer representatives and others, answering questions and advancing reimbursement and collection efforts.
  • Proven understanding of processes, systems and techniques to ensure successful billing and collection working with all payer types.
  • Proven ability to identify gaps and problems from review of documentation, determine lasting solutions, make effective decisions, and take necessary corrective action.
  • Proficient with MS Word, Excel and Outlook.

Education/Experience Requirements:

  • High School Diploma or equivalent required plus additional specialized training in medical billing preferred.
  • Minimum 3 years’ medical collections experience. Working knowledge of managed care, commercial insurance, and Medicare and Medicaid reimbursement preferred. Coding Course Certification highly preferred.
  • Working knowledge of automated billing systems, experience with CPR+ preferred.
  • Coding Course Certificaiton is highly preferred.

Additional Information

All your information will be kept confidential according to EEO guidelines.

Vacancy expired!


Related jobs

Report job