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You will coordinate with patients, insurance providers, and government agencies to resolve inquiries, set up payment plans, and reduce delinquent accounts while upholding privacy and policy standards.
The Credit and Collection Specialist is responsible for monitoring patient accounts, securing payment for hospital services, and managing outstanding receivables. This role involves coordinating directly with patients, insurance providers, and government agencies (e.g., PhilHealth, HMOs) to resolve billing inquiries, arrange payment plans, and reduce delinquent accounts while providing compassionate patient care.
Review open balances, identify past-due accounts, and initiate collection efforts via phone calls, emails, and demand letters
Coordinate with health insurance providers and HMOs to verify coverage, track unpaid claims, and resolve billing rejections or short payments
Meet with self-pay patients or families to discuss outstanding balances, assess financial hardship, and set up manageable, approved payment arrangements
Address patient inquiries regarding bill breakdowns, investigate billing discrepancies, and collaborate with internal departments (Billing, Medical Records) to make accurate adjustments
Track non-collectible accounts, prepare documentation for supervisor review, and recommend eligible accounts for third-party collection agencies or legal review
Ensure all collection activities adhere to medical privacy regulations and hospital policy while maintaining daily logs and aging reports
Bachelor's degree in Finance, Business Administration, Accounting, or a related field (or equivalent healthcare billing experience)
1-3 years of credit, collections, or medical billing experience in a hospital, clinic, or healthcare setting
Proficiency in hospital information systems (HIS), electronic health record (EHR) software, and MS Excel
Strong negotiation, interpersonal, and active listening skills
Familiarity with medical insurance, HMO procedures, and local healthcare coverage programs
High empathy and professional judgment when handling sensitive patient situations