Billing & Collections Specialist I

Socket.dev; Irving (TX); On-site; USD 33,000 - 36,000; Full time

Job summary

Socket.dev in Irving, TX is seeking a Billing & Collections Specialist I to manage patient and insurer balances, follow up on claims, and communicate to maximize reimbursement.

The role requires attention to detail, the ability to handle multiple tasks, proficiency with Patient Management Software, and strong communication. You''ll work with the RCM team to resolve denials and issue statements.

Qualifications

• Ability to manage multiple priorities with frequent interruptions.
• Excellent oral and written communication skills.
• Ability to meet deadlines.
• Problem-solving skills and strong interpersonal abilities.
• Must be a team player with collaboration skills.
• Proficient in computers and patient management software.
• Basic math skills (adding and subtracting).

Responsibilities

• Communicate with patients, practice partners and coworkers about balances and billing.
• Utilize MY Transworld Health to send patient accounts to profit recovery and collections.
• Update systems with information regarding disputes and remaining balances.
• Send statements to update patients on balances and bad debt.
• Maintain records of statements and emails related to billing.
• Update billing systems to reflect collection status and patient payments.
• Identify issues affecting payments and collaborate on resolutions with the manager.
• Provide explanations of benefits and justify balances to patients.
• Run aging reports and follow up on insurance claims awaiting payment.
• Review errors and implement resolutions; maintain accuracy rates.
• Initiate review of accounts with credit balances and issue refunds when necessary.
• Ensure insurance pays correctly and post adjustments as required.
• Create contact notes with reminder dates for timely follow-up.
• Process or record credit card payments taken over the phone.
• Communicate with practice on discretionary adjustments posted.
• Maintain a 96%+ accuracy rate; perform additional duties as assigned.

Skills

Multitasking

Communication skills

Deadline oriented

Problem solving

Team player

Computer proficiency

Math skills

Education

High School diploma, GED or equivalent

Tools

MY Transworld Health

Patient Management Software

Job description

Job Details

Job Location: USOSM HQ MAIN COMPANY - Irving, TX, Position Type: FT1, Salary Range: $24.00 - $26.00Hourly, U.S. Oral Surgery Management 500 E. John Carpenter Freeway, Suite 300 | Irving, Texas 75062 Billing & Collections Specialist I

POSITION PURPOSE

The primary duties and responsibilities include the ability to follow up with insurance and/or patient balances which include obtaining claim status, researching rejections and denials, and documenting related account activities. Actively reach out to patients to discuss outstanding balances when denied by insurance and collect balances. Communicate with and support other RCM staff, patients, partner practices and insurance companies to maximize reimbursement and ensure rapid account resolution.

PRINCIPAL RESPONSIBILITIES AND DUTIES

• Communicate with patients, practice partners and coworkers by answering telephone, emails messages and TEAMs messages to assist with any questions or apprehensions regarding balances, billing, collections and reimbursement.
• Utilizes MY Transworld Health website to send patient accounts to profit recovery and collections.
• Updates My TSI with additional information regarding patients’ failure to pay remaining balances if patient submits a dispute.
• Send email with statements to update patients on remaining balances and bad debt.
• Maintains a record for practice with all sent statements and emails regarding billing to patients.
• Updates billing systems to reflect status of collection and patient payments.
• Identifies possible issues or concerns that may impede insurance/patient payments and collaborates with manager to construct a resolution for issue.
• Provides a thorough explanation of benefits to patients and properly explains reasoning behind balances and collections.
• Runs aging report weekly, monitors bucket which includes money in insurance claims that still needs to be collected and follows up with insurance to find reasoning behind outstanding, rejected or pending claims.
• Reviews errors and provides resolution to issues. (Manager may assign report via email)
• Initiates review of patient accounts with credit balances and issues refunds when necessary.
• Ensures insurance pays correctly and issues adjustments following state law and USOSM protocol.
• Create contact notes with reminder dates to ensure claims are follow- up on timely.
• Pulls zero pay and applies insurance adjustment, updating billing category.
• Follows appropriate procedures before moving patients balance to collection agency.
• Processes/or gives to poster any credit cards when taken over the phone.
• Communicates with practice on accounts needing discretionary adjustments posted.
• Must maintain the accuracy rate determined by manager while training and then maintain 96% or better Performs additional duties as assigned by manager or director.

minimum qualifications

• Basic Knowledge & Competencies: Ability to manage multiple priorities with frequent interruptions Excellent oral and written communication skills Ability to meet deadlines Problem-solving skills Exceptional human relations skills Must be a team player Proficient in use of computers and Patient Management Software Adding and subtracting math skills

Previous Experience/Education

• High School diploma, GED or equivalent
• Experience in a medical and /or dental environment a plus
• An equivalent combination of education and experience is acceptable

PHYSICAL REQUIREMENTS

While performing the duties of this job, the employee is regularly required to sit for prolonged periods. Occasional lifting and bending to carry boxes and supplies, up to 25 pounds, may be required.