Position Summary:
The Collections and Payments Specialist is responsible for the performance of a broad range of collection activities related to obtaining payment for past due health insurance claims. The Collections and Payments Specialist will maintain expertise in organizational collection policies, dispute resolution, appeals management, and payment reconciliation in order to support a best-in-class patient care platform. The Collections and Payment Specialist will also demonstrate proficiency in multiple applicable software systems in addition to growth in areas supporting physician services including physician-administered drugs, imaging, and other ancillaries.
Responsible To:
Director, Revenue Cycle Management
Education/Experience:
High School Diploma or equivalent (GED) required
Prior physician office and infusion drug experience highly preferred
Excellent interpersonal, communication and organizational skills required
Ability to prioritize, problem solve, and multitask is required
MAJOR RESPONSIBILITIES
Proactively performs collections activities in accordance with established guidelines to interact with third party payors and patients for the purpose of collecting past due health insurance claims
Achieves daily accomplishments that produce progress towards monthly, quarterly and annual cash collection and accounts receivable goals
Actively engages in assigned quality assurance tasks to safeguard accurate and timely collections creation including compliance with organizational policies and payor guidelines
Identifies and researches validity of past due and/or disputed claims to expedite appropriate action in securing timely payment
Identifies areas of opportunity or potential patterns of noncompliance during normal course of responsibilities and escalates appropriately for review
Negotiates payment plans, partial payments and extensions of credit with appropriate reports for escalation to management review
Performs other duties as required.