Collections Reimbursement Specialist (Temp to Perm)

Job Description

Job Description

Seeking a skilled and experienced Collections Reimbursement Specialist to work out of our office in South New Jersey. In this role you will ensure timely, accurate reimbursement for healthcare services, manage outstanding balances, verify insurance details, file claims, and follow up with payers to resolve denials and secure payments. This role requires someone who can manage multiple priorities in a fast-paced environment with accuracy and professionalism. Strong communication, organization, and problem-solving skills are essential, as is the ability to work independently and embrace change. If you’re ready to utilize your collections experience to contribute to a dynamic team, send in your application today!

RESPONSIBILITIES:

• Run and review aging accounts receivable reports
• Identify and report payer denial trends and resolve outstanding accounts receivable
• Share payer trending data with internal departments to ensure a reduction in the number of denials
• Manage timely insurance denial, appeal and claim follow up activities to maximize collection efforts
• Review collection worklists
• Ensure timely follow up on all patient and insurance refund requests and credit balances
• Recommend and complete account adjustments, where appropriate
• Identify insurance contract opportunities/requirements and communicates to the Payor Relations department
• Answer and respond to telephone, email, and faxed inquiries from internal and external customers, which include clients, patients, and insurance carriers, while providing excellent customer service
• Analyze and determine accounts to transfer to External Agency for collection
• Accept and negotiate payment arrangements and contact patient(s) regarding missed payments
• Assist with obtaining prior authorizations
• Provide patient balance estimates and verify insurance for all payers, including Medicare, Medicaid, and commercial insurances
• Identify underpayments and overpayments made by third-party payers while monitoring credit balance report
• Process patient financial hardship applications and review requests for account adjustments
• Process, sort, and direct incoming and outgoing mail to the appropriate teams and departments
• Maintain patient accounts by appropriately notating, updating, and collecting patient demographic, and insurance information
• Request medical records and other patient information, when appropriate
• Provide management team with immediate feedback on issues affecting workflow, reimbursement, and customer service
• Attend staff meetings and report on monthly performance and activities
• Adheres to appropriate quality control, confidentiality, and HIPAA guidelines

QUALIFICATIONS:

• Bachelor’s degree preferred
• Minimum 5 years of Medical Accounts Receivable, Medical Billing, Customer Service, Denial Management and
• Collections experience
• Previous experience with medical claims processing, insurance verification, medical records and insurance
• terminology
• Competency with Windows PC Applications, including strong Microsoft Word and Microsoft Excel skills
• Proven ability to collect and resolve aging accounts receivable balances

Note: Qualified candidates will be contacted within 2 business days of application. If an applicant does not meet the above criteria, we will keep your resume on file for future opportunities and may contact you for further discussion.
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