Medical Collections Specialist
7115 FM 2920 North Houston, Texas 77379
Donovan and Watkins has partnered with a North Houston medical services client that is seeking contract-to-hire Medical Collections Specialists and Customer Service Representatives! The strongest candidates will have 1+ years surgery center/imaging-related medical collections or business-to-business customer service experience and be proficient in MS Word and Excel, in addition to having a stable job history and a positive and professional can-do demeanor. Great work environment with full benefits! This is the type of company from which you can retire!
The Medical Collections Specialists report to the AR Supervisor, and are responsible for a broad range of collections processes related to medical accounts receivable in support of multiple clients. These Medical Collection Specialists will proactively work assigned accounts to maximize accurate and timely payments.
The Customer Service Representatives support the Medical Collections Specialists by confirming preliminary status prior to the Specialists' making collections-related calls/inquiries.
- Follow-up open/pending insurance claims
- Prepare and submit insurance claims appeal letters
- Phone contact with medical insurance companies
- Ability to maintain daily productivity standards
- Understands the rules, regulations, payment reconsiderations, appeal process and timely filing regarding insurance billing coverage and collections process
- Understands payer determination, covered and non-covered items, diagnosis, modifiers, valid HCPC, authorization, eligibility, etc.
- Daily records each transaction worked on a Work Productivity log and client database
- Ability to read and understand EOBs to determine correct reimbursement
- Understands how to rectify underpayments with insurance companies for additional reimbursement
- Works on claims, denials, appeals and aging reports to determine the appropriate follow-action
- Ensures that goals set for denials/correspondence and aged accounts are met within the set guidelines given by your supervisor
- Maintains accurate and complete records concerning billing and collection activities
- Identifies and corrects billing errors and re-submitting claims to insurance carriers
- Handles customer and insurance questions concerning account activities
- Supplies supervisor or manager with current account status for collections evaluation
- Acts cooperatively and courteously with patients, visitors, co-workers, and management
- Communicates problems and concerns with supervisor/manager, which may lead to inaccurate or untimely completion of reimbursement processing
- 1+ years’ experience in insurance collections (and/or corporate Customer Service)
- High school diploma/GED
- Demonstrated job stability
- Knowledge of medical insurance payers, billing rules and regulations
- Experience in healthcare/medical industry - out-of-network experience preferred
- Excellent time management skills to complete projects and assignments as scheduled
- Be able to work on multiple tasks
- Plan and prioritize activities to achieve results and meet deadlines
- Strong communication, problem solving and analytical skills
- Ability to work independently and adapt to a fast-changing environment
- Proficiency in Microsoft Office including Excel and Word
- Strong organizational skills and detail oriented
- Excellent interpersonal and customer relationship skills with the ability to work in a very fast-paced environment
For consideration for this opportunity, please select apply and attach your Word-formatted resume!