Medical Collections Specialist

Revenue Cycle Associate - Collections Position Details: Employment Type: Full Time Location: Remote Reports to: RCM Manager You must reside in one of these states to be eligible for this position: Arkansas    California    Kentucky Massachusetts Nevada    New Mexico Oregon     Utah     Tennessee Texas     Wyoming Job Summary: Performs hospital revenue cycle functions related to insurance accounts receivable, denial management, appeals, self-pay collections, correspondence processing, and other assigned revenue cycle activities. Researches and resolves reimbursement issues while ensuring compliance with payer requirements and organizational policies. Responsibilities may vary based on departmental needs, business priorities, assigned work queues, and cross-training requirements. Key Responsibilities: Performs collection activity to ensure proper resolution and reimbursement of claims. Research denials and write appeals where necessary. Resolves claim processing issues with third party payers and provide all information required in a timely manner; involves also working with patients to ensure timely resolution to maximize reimbursement. Understands payer guidelines for unpaid claim resolution as well as help patients understand their responsibility. Monitors and recognizes reimbursement trends, recurring denials, or workflow issues to escalate concerns to leadership. Meets goals and objectives of the department which include productivity and quality minimum standards. Resubmits clean and accurate claims to insurance companies in a timely and compliant manner. Processes payer and patient correspondence, including requests for additional information, reconsiderations, and other revenue cycle communications. Highly detail oriented and organized with critical thinking and problem-solving skills. Ability to establish and maintain effective working relationships and communicate with customers, patients and insurance companies. Strong customer service skills to de-escalate difficult calls and remain professional. Knowledgeable and proficient with payer websites and other useful resources. Ability to work independently within a remote structure with no distractions. Required Skills & Qualifications: Knowledge of hospital revenue cycle workflows, reimbursement methodologies, and payer regulations. Highly detail oriented and organized with critical thinking and problem-solving skills. Ability to establish and maintain effective working relationships and communicate with customers, patients and insurance companies. Strong customer service skills to de-escalate difficult calls and remain professional. Knowledgeable and proficient with payer websites and other useful resources. Ability to work independently within a remote structure with no distractions. Work Experience, Education and Certifications: High school graduate or equivalent. Minimum experience of one year working with hospital revenue cycle, patient financial services, or insurance accounts receivable with a preference of 2-4 years. Working knowledge of Commercial, Medicare, Medicaid and managed care billing and reimbursement. Benefits: Competitive salary and benefits package. Opportunities for professional development and advancement. Supportive work environment with a collaborative team. Comprehensive healthcare coverage. Retirement savings plan. Paid time off and flexible scheduling options. Student loan repayment program.