Medical Collections Specialist

Medical A/R Collections SpecialistCMMC South Campus - Floresville, TX 78114OverviewPosition Type Full-Time/Part-Time Job Shift Day Education Level High School Travel Percentage None Category General BusinessDescriptionSummary Responsible for all aspects of Medical A/R collections, claim status and denial management.Essential Duties and Responsibilities include the following. Other duties may be assigned as needed to meet our department productivity standards.Completes follow up on outstanding medical A/R insurance claims with no response directly with payersWorks various denials from insurances including coverage in question, medical necessity, re-bundled, incorrect coding, credentialing, etc.Reviews electronic rejectionsCompletes incoming correspondence from patients and or insuranceWorks with coders on any coding and billing issues to correct and or appeal errors in a timely mannerInitiates refund/credit requests.Properly documents the patient account of all steps taken to resolve balance pending by payer or patientEscalate problems with electronic claims submissions and or bulk rejections to manager for assistance and guidance for resolution.Bulk mails all manual claims to individual payers daily as neededWorks daily, weekly and monthly aging reports as assignedQualificationsEducation and/or ExperienceStrong, working knowledge of insurance payers to include government, commercial and managed care products.Ability to establish a good rapport with Clinic managers and Providers.Resourceful, steadfast attitude to make sure that claims are worked timely.Comfortable with navigating through the payer websites for claim status, appeals, etc..Excellent verbal and oral communication skills.Excellent customer service skills are expected with patients and clinic staff.Other QualificationsMust be able to multitask and demonstrate excellent time managementMust work well in a team environmentAbility to communicate well with patients and other team members in a tactful and courteous mannerProtect PHI and follow HIPPA regulationsRequired to meet department quality and production standardsMaintaining and satisfying minimum attendance requirements is an essential function of this position including working all full-time regular hours as establishedKnowledge of CPT/HCPCS and ICD-10.2 years' experience preferred in a medical office setting.