Overview

Department: Billing

Position: Collection Specialist

Employee Category: Non-Exempt

Reporting Relationship: Manager of Revenue Cycle Management

Character First qualities:

* Decisiveness- The ability to recognize key factors and finalize difficult decisions.

* Dependability- Fulfilling what I consented to do, even if it means unexpected sacrifice

* Initiative - Recognizing and doing what needs to be done before I am asked to do it.

* Thoroughness - Knowing what factors will diminish the effectiveness of my work or words, if neglected.

* Flexibility - Willingness to change plans or ideas without getting upset.

Summary of Duties and Responsibilities:

The Bilingual Collection Specialist will be responsible for working directly with patients and third-party payers to effectively resolve all unpaid claims. The primary focus is to maximize revenue for the organization and consistently work to improve the overall health of the Accounts Receivable (AR).

Responsibilities

Primary Duties and Responsibilities:

Work collaboratively with the Senior Collection Specialist and the Manager of Revenue Cycle Management to determine the focus of collection efforts after running the weekly AR report. Contact third-party payers about outstanding balances and provide requested documentation to achieve resolution. Contact patients with outstanding balances to obtain payment or set up payment plan. Send out patient statements and collection letters on past due balances. Track and follow-up monthly on payment plans to ensure compliance. Perform write-offs, adjustments and refunds as directed. Work closely with the Billing team to initiate and respond to billing inquiries, requests for additional information and outstanding balance resolution. Answer patient calls and billing questions. Process medical records requests for payers from attorneys. Assist front desk staff with patient inquiries. Assist front desk staff with obtaining correct patient addresses. Meet established daily, weekly, monthly and annual deadlines. Manage and maintain relationships with all payors to improve patient revenue. Uphold Medicare, Medicaid, and HIPAA compliance guidelines in relation to billing, collections, and PHI information. Follow written and verbal instructions from the Manager of Revenue Cycle Management and Sr. Collection Specialist. Exhibit professionalism in communication with patients, clients, insurance companies and co-workers. Participate in special projects as assigned. Supports Variety Care's accreditation as a Patient Centered Medical Home and our commitment to provide care to all Variety patients that is Safe, Effective, Patient Centered, Timely, Efficient, and Equitable. Provides leadership and work with all staff to achieve the goals of the "Triple Aim" of healthcare reform-to improve the experience of care, improve health outcomes, and decrease healthcare costs. Other duties as assigned.

Qualifications

Requirements, Special Skills or Knowledge:

High School Diploma or GED is required. Associate degree highly preferred or equivalent combination of experience and education. Two years prior billing and collections experience REQUIRED. Fluent in Spanish is a REQUIREMENT. Must be able to speak Spanish and communicate effectively with the Spanish speaking patient population. Prior medical billing and insurance collections or healthcare revenue cycle experience including diversified experience with payers, managed care contracts, and payer methodology is preferred. Working knowledge of CPT codes. Ability to read and understand Explanation of Benefits (EOB) issued by insurance carriers. Demonstrated mastery of critical independent thinking, analytics, problem-solving and sound decision-making skills required. Demonstrated ability to interact and communicate effectively with individuals at various levels both inside and outside the organization, often in sensitive situations. Proficiency and clerical accuracy with Microsoft Office and practice management software systems. Professionalism, integrity, responsibility and dependability in a team environment. Ability to assist and support others in a professional and respectful manner.

ADA Requirements:

Must be able to lift and/or move up to 25 pounds. While performing the duties of this job, the employee is frequently required to sit, stand, walk and talk. Frequently required to bend and reach to fulfill job duties.