We are a growing healthcare service provider, specializing in medical devices and related products and services for patients in hospitals, clinics, ambulatory surgery centers, and other major service centers. We provide direct payer rentals, pump and consumable sales, and biomedical services and repair, serving all 50 states and Canada.

Summary:

The Revenue Cycle AR/Collections Specialist is responsible for the management of activities relative to third party payer collections. This includes, but is not limited to, performing accounts receivable management, following up on denials/non-payments, filing appeals for medical necessity, benefit coverage, etc. This position should have collections work experience in DME and other healthcare-related services.

This role will be responsible for hitting regular productivity targets with a high level of quality. Quality audits will be performed on a regular basis and feedback and education will be provided to help support professional growth and development.

Core Responsibilities:

• Monitor accounts receivable aging to ensure timely resolution of claims
• Ability to identify and report any trends causing future potential denials
• Ensure payment accuracy
• Must be able to interpret payer explanation of benefits (EOBs)
• Review payer denials, analyze accounts, and determine the next appropriate steps to achieve payment success. This will include payer portal review and phone calls to payers.
• Successful candidates will have the ability to clearly and concisely communicate the issues that they are seeing and request payer representatives to assist with resolution.
• Conduct insurance reverification as needed through various eligibility tools
• Research, write, and submit appeals as appropriate
• Process third party payer correspondence, refunds, and adjustments
• Accurately and thoroughly document the pertinent collections activities in appropriate systems
• Respond to all patient inquiries timely
• Remain up to date on payer medical policy notices and changes
• Share information and ideas for process improvements with team
• Comply with all work instructions, policies, and behavioral expectations

Successful Candidate Experience:

• Minimum 2 years’ related experience within collections; or equivalent combination of education and experience
• Medical Collections experience is highly preferred
• Understanding of insurance guidelines including Medicare, Medicaid, Workers Compensation, and all Commercial managed-care plans
• Ability to explain and resolve collections-related questions/issues to patients, sales representatives, and facilities
• Proper use of ICD-10, CPT, and HCPCS codes
• Ability to handle inquiries and respond via telephone or in writing
• Ability to independently meet tight deadlines in a project-based atmosphere
• Operate Express/HDMS/Waystar proficiently

Job Type: Full-time

Pay: $17.00 - $23.00 per hour

Expected hours: 40 per week

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Experience level:

• 2 years

Schedule:

• Monday to Friday

Supplemental pay types:

• Bonus opportunities

Work Location: In person