Collections Specialist

Summit BHC; Franklin (TN); Remote; USD 25,000 - 39,000; Full time

Job summary

Summit Healthcare Mgmt is seeking a Collections Specialist to manage accounts receivable, focusing on insurance follow-up and timely reimbursement. The role operates within the Centralized Business Office and requires attention to detail in resolving discrepancies.

Responsibilities include pursuing payments from payers and patients, maintaining productivity, and preparing adjustments. Remote work option offered with emphasis on accurate, timely AR activities and collaboration with UR teams.

Qualifications

• Three or more years of hospital or physician insurance collector experience required.
• Prefer behavioral health experience.
• Knowledge of UB04 forms, HCFA 1500 forms, CPT-4 and ICD-10CM coding.

Responsibilities

• Pursues payment from third party payers and patients. Initiates contact with third-party payers and tracks payment progress.
• Ensures assigned follow up queue is current and noncompliance accounts are limited to no more than 7 days delinquent for follow-up.
• Prepare adjustment forms and refund requests for management approval.
• Reports payer and denial trends to upper management through continued communication with local UR teams.
• Participates in AR Review calls with assigned facility.
• Managed daily productivity via patient accounting system and productivity reports. Needs to maintain an average of 40 accounts worked per day minimum.
• Research slow or disputed claims and takes appropriate action.
• Generates AR reports as required by management.

Skills

Communication skills

Education

High School or GED

Associate degree preferred

Tools

UB04 forms

HCFA 1500 forms

CPT-4 coding

ICD-10CM coding

Job description

Collections Specialist | Summit Healthcare Mgmt | Nashville, Tennessee

About the Job:

PURPOSE STATEMENT:

The Collections Specialist is responsible for providing AR management to include insurance account follow up in a timely and effective manner using healthcare business software applications as a part of the Centralized Business Office team. Responsibilities include recording receivable activities, identifying and resolving account discrepancies to ensure timely reimbursement.

Roles and Responsibilities:

ESSENTIAL FUNCTIONS:

• Pursues payment from third party payers as well as patients when needed. Initiates contact with third-party payers and tracks payment progress.
• Ensures assigned follow up queue is current and noncompliance accounts are limited to no more than 7 days delinquent for follow-up.
• Prepare adjustment forms and refund requests for management approval.
• Reports payer and denial trends to upper management through continued communication with local UR teams.
• Participates in AR Review calls with assigned facility.
• Managed daily productivity via patient accounting system and productivity reports. Needs to maintain an average of 40 accounts worked per day minimum. Definition of worked account means activity that produces resolution of payment. Worked accounts will be sampled to assure steps taken did or will assist in payment.
• Research slow or disputed claims and takes appropriate action.
• Generates AR reports as required by management.

EDUCATION/EXPERIENCE/SKILL REQUIREMENTS:

• High School or GED required, Associates degree preferred.
• Three or more years of hospital or physician insurance collector experience required. Prefer behavioral health experience.
• Knowledge of UB04 forms, HCFA 1500 forms, CPT-4 and ICD10CM coding.
• Excellent written and verbal communication skills.

LICENSES/DESIGNATIONS/CERTIFICATIONS:

Not Applicable.

WORK LOCATION:

This position is remote.

SUPERVISORY REQUIREMENTS:

This position is an Individual Contributor.

Why Summit Healthcare Mgmt?

Summit Healthcare Mgmt offers a comprehensive benefit plan and a competitive salary commensurate with experience and qualifications.

Summit Healthcare Mgmt is an EOE.

Summit BHC is dedicated to serving Veterans with specialized programming at our treatment centres across the country. We recognize and value the unique strengths of the military community in supporting our mission to serve those who have served.