Hospital Collection Specialist

Job Title:  Hospital Collection Specialist                                             Report to: AZ CEO and Billing Manager 
Department:  Billing                                                                               Job Level:  Clinical / Professional
Developed: 04/2024                                                                              Approved by:  COO, HR Job Summary:   At Exceptional Healthcare, we combine innovative technology with a commitment to providing the best possible outcomes to our patients. We’re searching for an experienced and reliable Collection Specialist to join our team. Our staff plays an integral role in fueling the care and healing that happens here at Exceptional Healthcare.
The collections specialist is responsible for collecting any sort of payment that is due to Exceptional Healthcare. This includes cash payments, ACH, or checks. This position ensures the highest quality and safe delivery of customer service, maintain compliance with professionalism and regulatory processes and requirements. To succeed in this role, you must possess a strong background of the benefits and insurance carriers. This involves performing collection activities related to follow-up and account resolution, and includes communication to patients, clients, reimbursement vendors, and other external entities while adhering to all guidelines. Patient and client satisfaction is essential.
Job Responsibilities/Duties:
 

• Excellent Customer Service.
• Courtesy and respect for every staff member.
• Documents all findings accurately.
• Collects and processes payment in person or over the phone.
• Makes outbound calls to resolve the patient account.
• Documents all collections activity performed on each account in the system.
• Update the patient account record to identify actions taken on the account.
• Analyzes account for errors, adjustment, credits, issuing corrected entries when required. Escalates complex issues and updates patient account information.
• Provide regular feedback to management, based on research and calls to payers, to establish payer behavior trends.
• Prepare required appeals relating to past timely filing, medical necessity, and other claims.
• Sort and file correspondence.
• Establishes and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations.
• Demonstrates knowledge and understanding of Insurance and benefits.
• Maintains the privacy and security of all confidential and protected health information uses and discloses only that information which is necessary to perform the function of the job.
• Utilizes excellent written and oral communication skills to collaborate and maintain positive working relationships with peers, leaders, departments, and payer representatives to resolve patient/credit balances.

Qualifications & Experience:
 

• High School Diploma or GED.
• Some college, Associates, or bachelor’s preferred.
• Minimum 2-3 years of patient experience or customer service experience preferred.
• Minimum 2-3 years with a deep background in Insurance preferred.
• Minimum 2-3 years with a deep background in Benefits preferred.

Knowledge Skills & Abilities

• Extremely conscientious with excellent organizational skills.
• Capable of working independently and as a team member.
• Must be very customer service oriented.
• Broad knowledge of the content, intent, and application of HIPPA, federal and state regulations.
• Knowledge with in and out of network insurances, insurance verification, patient responsibility, and process for prior authorization.
• Ability to stay focused in a fast-paced environment, manage time efficiently, and able to multi-task.

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