Collections Specialist

United Surgical Partners International; Cedar Park (TX); On-site; USD 42,000 - 62,000; Full time

Benefits offered by this job

Medical, dental, vision coverage

Life and AD&D coverage

Short- and long-term disability

FSAs and HSAs

401(k) retirement plan

Paid holidays and vacation

Job summary

USPI Hill Country Ambulatory Surgery Center, part of United Surgical Partners International, seeks a Collection Specialist to manage delinquent claims. You will interpret contracts, determine reimbursements, and appeal as needed while maintaining professional communication with insurers and patients.

Weekdays only; some early mornings or late evenings may occur. Responsibilities include identifying mispaid accounts, issuing credit information, and collaborating with the business office to meet

Qualifications

• High School Diploma or equivalency required.
• 3-4 years collections experience in healthcare settings preferred.
• Experience with electronic patient information systems.
• Understanding of medical terminology and payer contracts.

Responsibilities

• Follow up on delinquent surgery center claims with carriers and patients.
• Interpret managed care contracts, Medicare/Medicaid/Workers’ comp claims.
• Calculate allowable reimbursements and determine appropriateness.
• Appeal claims as necessary and communicate outcomes.
• Identify under/over payments and issue credit information.

Skills

Excellent communication skills

Interpersonal skills

Time management

Prioritization of emergent situations

Customer service

Typing speed 45-60 WPM

Microsoft Office

Independent worker

Critical thinking

Education

High School Diploma or equivalency

Tools

Electronic patient information systems

Microsoft Office suite

Job description

USPI Hill Country Ambulatory Surgery Center is seeking a motivated Collection Specialist to join our team. We have 1 OR room and 3 Procedure rooms. We perform outpatient surgical procedures in Gastroenterology. Position requires weekdays only -- no holidays, weekends, or call. Some early mornings and later evenings may be required; schedule subject to change based on surgical schedule and flow of the day.

JOB SUMMARY

Under the direction of the Business Office Manager, the Collections Specialist is responsible for follow up on delinquent surgery center claims, working an expected number of claims per day. Majority of claims will have been submitted to various insurance carriers electronically. Knowledge of how to interpret a managed care contract, Medicare and Medicaid and Workers Compensation claims is a must. You will be given tools to calculate allowable and required to determine appropriateness of reimbursement and appeal claims as necessary. Extensive contact with insurance carriers of all types, as well as communication with patients regarding out-of-pocket amounts is required. Identification of accounts that have been either under or over paid, issuing credit balance information either to the insurance carrier or the patient. All of these practices done in a professional and communicative manner, per policies and procedures, guidelines, internal control measures and established goals.

What We Offer

As an organization, one way we care for our communities and each other is by providing a comprehensive benefits package that includes the following, subject to employment status:

• Medical, dental, vision, and prescription coverage
• Life and AD&D coverage
• Availability of short- and long-term disability
• Flexible financial benefits including FSAs and HSAs
• 401(k) and access to retirement planning
• Paid holidays and vacation

Who We Are

At USPI, we create relationships that create better care. We partner with physicians and healthcare systems to provide first-class ambulatory solutions throughout the United States. We are committed to providing surgical services in the most efficient and clinically excellent manner.

USPI is committed to, and proud of our inclusive culture. An inclusive culture, in our view, is respectful of differences and nurtures and supports the contributions of each individual, while also embracing and leveraging diversity. A diverse workforce, combined with an inclusive culture, makes USPI stronger and better able to meet the needs of our diverse patient and physician population.

Required Skills

Qualifications

• High School Diploma or equivalency.
• 3-4 years previous collections experience, with emphasis on healthcare insurance collections of all types. (preferably in an ambulatory surgical setting)
• Experience with electronic patient information systems.
• Medical terminology.
• Ability to work independently.
• Excellent communication skills and interpersonal skills.
• Skilled in time management and prioritization of emergent situations.
• Good customer service skills, always demonstrates professionalism.
• Comfortable utilizing critical thinking skills.
• Typing 45-60 WPM.
• Proficient with Microsoft Office products.