Collections Specialist

Job Details

Qualifications:

• High school diploma or GED required; Associate degree in Accounting, Business, or Healthcare Administration preferred.
• Minimum 1–2 years of experience in medical collections, healthcare billing, or a similar role in a hospital or clinic.
• Familiarity with EHR and billing systems (e.g., Epic, Cerner, Meditech) is highly desirable.
• Strong knowledge of insurance claims processes, CPT/ICD-10 coding basics, and third-party payer requirements.
• Excellent communication, negotiation, and problem-solving skills.
• Ability to manage multiple accounts and prioritize tasks in a fast-paced environment.

Responsibilities:

• Monitor and manage aged accounts receivable for both patient and insurance balances.
• Contact patients, insurance companies, and third-party payers to collect overdue balances via phone, email, or written correspondence.
• Review and resolve claim denials and underpayments, including filing appeals when necessary.
• Work closely with the billing team to ensure accurate claim submissions and resolve billing discrepancies.
• Educate patients on their balances, insurance coverage, and payment plan options.
• Document all collection activities and patient interactions in the hospital's electronic health record (EHR) or billing system.
• Meet or exceed departmental productivity and collection goals.
• Stay updated on payer guidelines, insurance policies, and federal/state regulations (HIPAA, FDCPA, etc.).
• Maintain patient confidentiality and treat all individuals with respect and professionalism.
• Follow-up on accounts with outstanding balances that do not have appropriate payment arrangements.

Physical Demands:

• Prolonged periods sitting at a desk and working on a computer.
• Occasional lifting of office supplies and files (up to 15 lbs.).

Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.