Collections Specialist

Oceans Healthcare; Mount Juliet (TN); Remote; USD 35,000 - 50,000; Full time

Job summary

Oceans Healthcare is seeking a Collections Specialist for a remote opportunity, preferably located in the Nashville area. This entry-level position involves managing billing and collection processes, requiring a strong knowledge of insurance plans and excellent communication skills. Candidates should be able to work independently while adhering to federal and state regulations, providing a vital role in the financial health of the organization.

Qualifications

• Previous experience interpreting insurance plan benefits and billing requirements.
• Customer service experience in a similar field required.
• Familiarity with privacy laws and regulations.

Responsibilities

• Bill and collect outstanding receivables from third-party payers.
• Review and submit claims to ensure timely processing.
• Communicate with revenue cycle staff and management to resolve issues.

Skills

Microsoft Office

Patient accounting systems

Effective communication skills

Customer service

Teamwork ability

Education

High school diploma or equivalent

Job description

Join to apply for the Collections Specialist role at Oceans Healthcare.

1 week ago Be among the first 25 applicants.

Description

Collections Specialist - Remote Opportunity - Must be located in Nashville, TN area

The Collections Specialist is responsible for accurate and timely billing and collection of outstanding receivables from third-party payers and payer representatives. Maintaining accurate account balances in accordance with contractual obligations, fee schedules, or regulations is a required job duty.

Essential Functions

• Review third-party claims for accuracy and completeness using patient accounting functionality. Submit claims to third-party payers within timely filing restrictions.
• Perform follow-up activities by telephone or electronic inquiry on accounts with outstanding third-party payer balances to determine the status of claims in accordance with payer-specific follow-up guidelines.
• Attempt to expedite claim adjudication by resolving issues that may delay processing, involving the patient/guarantor as necessary.
• Document pertinent follow-up activity upon completion of each occurrence in the patient accounting system clearly and concisely.
• Resubmit claims to payers as necessary, including secondary or tertiary plan claims.
• Ensure accurate account balances for proper processing and reporting, requesting contractual allowances, adjustments, and balance transfers as needed.
• Communicate with other revenue cycle staff, Utilization Review/Case Management, and site leadership to ensure timely and accurate claims payments.
• Research and resolve credit balance accounts as requested by payers or as identified on aging reports.
• Complete daily and weekly productivity/performance reports as directed by management.
• Perform other duties and projects as assigned.

Educational / Experience Requirements

• High school diploma or equivalent as minimum requirement.
• Previous experience interpreting insurance plan benefits, payment conditions, and billing requirements.
• Previous customer service experience in a similar field, including employment as a call center worker, credit authorizer, or customer service representative. Strict adherence to FTC rules regarding collection attempts is required due to the sensitivity of financial records.

Qualifications

Skills and knowledge include:

• Experience with Microsoft Office and patient accounting systems.
• Knowledge of third-party payers, Medicare, Medicaid, and other requirements.
• Effective communication skills for resolving claim issues with insurance payers.
• Customer service skills for interacting with patients and families from diverse backgrounds.
• Ability to work in a team and with minimal supervision while respecting confidentiality.
• Adherence to policies and procedures compliant with state and federal laws and regulations.

Seniority level

• Entry level

Employment type

• Full-time

Job function

• Accounting/Auditing and Finance

Industries

• Hospitals and Health Care

This job posting appears active; no indications of expiration are present.