Collections Specialist Sr

Job Summary

The Collections Specialist Sr is responsible for a broad range of collection processes related to medical accounts receivable in support of single or multiple site locations. The employee will proactively work assigned accounts to maximize accurate and timely resolution of credit balances. The employee must have the ability to prioritize, problem solve, and multitask. The employee will work closely with other staff to identify, resolve, and share information regarding payer trends and guideline updates. Above all, qualified candidates should possess exceptional internal and external customer service skills.

• Ensures daily accomplishments work towards company goals for credit balance levels, cash collections and A/R over 30 days .

• Manages collection efforts with a high level of persuasiveness and professionalism · Understands and adheres to state and federal regulations.

• Understands and adheres to HIPAA and PHI guidelines.

• Arrange for debt repayment or establish repayment schedules · Documents system appropriately and notifies appropriate entity of primary claims that need to be resubmitted. as a result of cleaning up overall residual credit issues · Interacts with third party collection agency as needed · Schedules, conducts, and records meetings.

• Communicates consistently and professionally with other AmeriHealth Caritas employees, provider community and TPA's.

• Works within specified deadlines and stressful situations · Works overtime when necessary to meet department goals and objectives.

• Must be comfortable with Provider/Plan escalations.

• Will assist in system trainings/updates.

• Strong organizational and follow-up skills.

• Performs root cause analysis and follows up with analyzing, resolving and improving internal processes.

• Works with Legal and Finance personnel on aged outstanding balances.

• Ability to interact with management with recommendations and concerns.

• Performs other tasks or special projects as requested by management.

• Works with the check unit regarding processes for handling checks.

• Assist in onboarding of new business · Assist is training of onboarding associates.

• Must be able to maintain assigned providers and meet weekly SLA's.

• Must be comfortable with handling prompt escalated issues when management is not in office.

• Utilizes system applications including Microsoft Office (Excel, Access, Outlook, Word), Facets , Microsoft Sql Server.

Education/Experience:

• Associate's Degree or equivalent required.

• Bachelor's Degree preferred.

• 5+ years exp in Claims, Recovery or Collections background.

Our Comprehensive Benefits Package

Flexible work solutions include remote options, hybrid work schedules, competitive pay, paid time off, holidays and volunteer events, health insurance coverage for you and your dependents starting Day 1, 401(k) retirement savings plan, tuition reimbursement, and more.

Why Join Us : Your career starts now. We are looking for the next generation of healthcare leaders. At AmeriHealth Caritas, we are passionate about helping people get care, stay well, and build healthy communities. As one of the nation's leaders in healthcare solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services, and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together, we can build healthier communities. If you are driven to make a difference, we want to hear from you.

About AmeriHealth Caritas

Headquartered in Newtown Square, Pennsylvania, AmeriHealth Caritas is a mission-driven organization with over 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. Our services include integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at

As a company, we support internal diversity through:

Recruiting. We are an equal opportunity employer. We do not discriminate on the basis of age, race, ethnicity, gender, religion, sexual orientation, or disability. Our inclusive, equitable approach to recruiting and hiring reinforces our commitment to DEI.