Patient Collections Specialist

Job Description

Job Description

Job description:

The Patient Collections Specialist is responsible for managing patient account balances through timely and professional collection efforts while maintaining exceptional customer service. This position communicates with patients and insurance carriers regarding outstanding balances, processes account transactions, establishes payment arrangements, and ensures compliance with healthcare billing regulations and organizational policies. The Patient Collections Specialist works collaboratively with the billing team to maximize collections while maintaining patient satisfaction and confidentiality.

Essential Duties and Responsibilities

• Coordinate collection activities with internal collections staff and external collection agencies as appropriate.
• Review and monitor patient accounts with outstanding balances and perform timely follow-up activities.
• Run and review collection and financial reports to identify accounts requiring action.
• Collect pre-payment balances for scheduled elective procedures.
• Contact patients regarding outstanding balances through written and verbal communication while adhering to applicable collection laws and regulations.
• Answer incoming patient billing calls, respond to billing inquiries, collect payments, and direct calls to the appropriate staff member when necessary.
• Establish and maintain patient payment plans according to organizational policies.
• Post payments and other financial transactions accurately to patient accounts.
• Maintain detailed and accurate documentation of collection activities and patient communications.
• Ensure compliance with federal and state collection regulations, Medicare, Medicaid, commercial insurance, and Workers' Compensation guidelines.
• Protect patient confidentiality and comply with all HIPAA privacy and security requirements.
• Perform other duties as assigned by the Physician, Administrator, Supervisor, or other authorized leadership.

General Qualifications

• Proficient keyboarding and computer skills.
• Working knowledge of collection laws, regulations, and bankruptcy procedures.
• Knowledge of Medicare, Medicaid, commercial insurance, and payer guidelines.
• Knowledge of Workers' Compensation billing requirements.
• Knowledge of ICD-10 and CPT coding.
• Excellent organizational and time management skills.
• Strong verbal and written communication skills.
• Ability to maintain strict confidentiality.
• Ability to work effectively as part of a collaborative team.

Core Competencies

• Delivers outstanding customer service to patients and coworkers.
• Adheres to established organizational policies, procedures, and compliance standards.
• Demonstrates accountability and ownership of assigned responsibilities.
• Communicates professionally and effectively.
• Builds positive working relationships with patients, providers, and coworkers.
• Continuously seeks opportunities to improve job performance and work processes.
• Contributes positively to departmental and organizational goals.

Preferred Qualifications

• High School Diploma or GED required.
• Minimum of two (2) years of medical billing experience.
• Minimum of two (2) years of patient collections experience.
• Experience with Medicare, Medicaid, Blue Cross Blue Shield of Nebraska, and other Blue plans preferred.
• Experience using electronic health records (EHR) and medical practice management software preferred.

Physical Requirements

• Ability to sit for prolonged periods with occasional standing, walking, bending, kneeling, crouching, balancing, and stooping.
• Ability to independently lift and carry up to 50 pounds.
• Ability to push and pull up to 50 pounds.
• Ability to perform repetitive keyboarding and computer work throughout the workday.

Work Environment

This position is performed in a professional medical office environment and requires frequent interaction with patients, providers, insurance companies, and fellow staff members. The ability to maintain professionalism, accuracy, confidentiality, and excellent customer service while handling sensitive financial information is essential.

Benefits:

• 401(k)
• Dental insurance
• Flexible schedule
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Retirement plan
• Vision insurance

Education:

• High school or equivalent (Required)

Experience:

• Athenahealth: 1 year (Preferred)
• Medical office: 1 year (Preferred)

Work Location: In person