Collections Specialist - Remote

Surgery Partners, Inc; Nashville (TN); On-site; USD 55,000 - 75,000; Full time

Benefits offered by this job

Comprehensive health insurance

Health Savings Account with employer

Life Insurance

PTO

401(k) with company match

Job summary

Surgery Partners, Inc. is seeking a remote Medical Billing Specialist to manage denied claims, optimize accounts receivable days, and ensure accurate payer adjudication. You will analyze denial root causes, bill secondary/tertiary claims, and stay current with payer policies.

The role requires strong attention to detail, experience in medical billing, and the ability to communicate payer trends to leadership. Join a company committed to efficient revenue cycle operations from a remote setting.

Qualifications

• Experience with medical billing and denial management.
• Strong understanding of payer rules and regulations.
• Excellent numerical accuracy and attention to detail.

Responsibilities

• Research unpaid claims and identify denial root causes to ensure timely adjudication.
• Bill secondary and tertiary insurance claims.
• Stay current on third-party payer regulations and requirements.
• Communicate payer trends to management.
• Document all account resolution actions in patient records.

Skills

Claims billing

AR management

Payer negotiation

Data entry

Communication

Job description

Job Responsibilities:

• Research unpaid claims, determine denial root causes, and perform appropriate follow-up actions to ensure timely claim adjudication.
• Identify and take appropriate action for the billing of secondary and tertiary insurance claims.
• Remain informed of all current applicable third-party payer regulations and requirements.
• Communicate payer trends and patterns to management.
• Document all account resolution activities and actions taken within the patient's record.
• Review, comprehend, and execute payer logic within negotiated contracts.
• Prioritize workflow to reduce or eliminate bad debt and support a reduction in accounts receivable (AR) days.
• Meet and maintain established productivity and audit standards.
• Perform other duties as assigned by management.

Core Competencies

• Agility
  • Adapts quickly to changing circumstances and effectively navigates obstacles and constraints.
  • Remains comfortable with uncertainty and adjusts approaches to meet evolving business needs.
• Bias to Action
  • Takes initiative and moves work forward with a logical, solution-oriented approach.
  • Makes sound decisions and acts effectively, even without having the complete picture.
  • Demonstrates resilience and maintains focus on achieving goals despite challenges or setbacks.
• Customer Focus
  • Understands the needs and priorities of both internal and external customers.
  • Builds positive relationships and delivers service that meets customer expectations.
• Managing Complexity
  • Analyzes complex situations and identifies the most critical issues.
  • Distinguishes key information from distractions to solve problems effectively.
  • Identifies root causes of successes and failures to drive continuous improvement.
• Conflict Management
  • Resolves disagreements and disputes fairly and professionally.
  • Maintains a positive, constructive, and respectful approach during difficult conversations.
  • Works collaboratively to achieve mutually beneficial outcomes.

Location: Remote

Benefits:

• Comprehensive health, dental, and vision insurance
• Health Savings Account with an employer contribution
• Life Insurance
• PTO
• 401(k) retirement plan with a company match
• And more!

Environmental/Working Conditions:

Normal busy office environment with much telephone work. Possible long hours as needed. The description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities and working conditions may change as needs evolve.

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