Collections Specialist

United Surgical Partners International Inc (USPI); McDonough (GA); On-site; USD 42,000 - 64,000; Full time

Benefits offered by this job

Medical, dental, vision, and pharmacy

Life and AD&D coverage

Short- and long-term disability

FSAs and HSAs

401(k) and retirement planning

Paid holidays and vacation

Job summary

USPI Hill Country Ambulatory Surgery Center is seeking a motivated Collection Specialist to join our team. The role involves following up on delinquent surgery center claims and communicating with patients about out-of-pocket amounts, with a focus on accuracy and compliance.

You will work under the Business Office Manager to interpret contracts and insurance requirements, calculate allowable reimbursements, and escalate issues per policy while maintaining professional relations with carriers.

Qualifications

• High School Diploma or equivalency.
• 3-4 years healthcare insurance collections experience (ambulatory surgical setting preferred).
• Experience with electronic patient information systems.
• Medical terminology knowledge.
• Ability to work independently.
• Excellent communication and interpersonal skills.
• Strong time management and prioritization of emergent situations.
• Professional customer service demeanor.
• Typing 45-60 WPM.
• Proficient with Microsoft Office products.

Responsibilities

• Follow up on delinquent surgery center claims.
• Interpret managed care contracts, Medicare/Medicaid, and Workers' Compensation claims.
• Calculate allowable amounts and determine reimbursement appropriateness.
• Appeal claims as necessary.
• Maintain extensive contact with insurance carriers and patients regarding charges.
• Identify accounts with under- or over-payments and issue credit balance information.
• Ensure all procedures are performed professionally per policies and guidelines.

Skills

Communication skills

Interpersonal skills

Time management

Prioritization

Customer service

Typing speed

Education

High School Diploma

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.

#USP-123

#LI-CM1

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.