PFS Collection Specialist

Colorado In Motion; California; Remote; USD 42,000 - 60,000; Full time

Job summary

Colorado In Motion is seeking a detail-oriented professional to handle collection of commercial, government, and patient balances in a remote position. You will follow approved revenue cycle policies to maximize reimbursement and ensure accurate billing.

This role requires strong communication, organization, and problem-solving skills, with experience in a medical office setting preferred. A high school diploma or GED is required.

Qualifications

• Discretion and confidentiality required.
• Experience in a medical office setting preferred.
• Strong problem-solving and attention to detail.
• Excellent interpersonal, oral and written communication skills.
• Good organizational and time-management abilities.
• Ability to work well in a team and meet deadlines.

Responsibilities

• Monitors outstanding account balances and determines next steps in the collection process.
• Follows up on claims and denials to maximize reimbursement for services provided.
• Reviews accounts receivable activities and contacts patients or payors as needed.
• Generates paperwork including insurance claim forms and collection letters.
• Reviews EOBs to verify reimbursement and adjudicate claims.
• Investigates and appeals denied or underpaid claims.
• Responds to inquiries from patients and payors by phone or writing.
• Tracks and resolves discrepancies in accounts.
• Assists patients with setting up payment plans.
• Submits billing data to insurance providers.

Skills

Discretion and confidentiality

Medical office experience

Problem solving

Interpersonal communication

Organizational skills

Team collaboration

Deadline adherence

Education

High school diploma or GED

Job description

Overview

Position Summary:
Responsible for collecting commercial, government, and patient balances by following the approved processes, policies and procedures set by the revenue cycle department.

Responsibilities

Remote position

Essential Functions:

• Monitors outstanding account balances to determine the next step in the collection process.


• Follows up on claims and claim denials to ensure maximum reimbursement for services provided.


• Reviews accounts receivable activities and calls on outstanding balances or claims.


• Generates appropriate paperwork, including insurance claim forms (original and re-filed) and collection letters.


• Reviews insurance payments (Explanation of Benefits - EOB's) to determine whether reimbursement is accurate. Navigate portals to send claims for adjudication.


• Investigates and appeals denied or underpaid claims.


• Responds to all inquiries received from patients and payors either by telephone or written request.


• Tracks and resolves discrepancies.


• Follows-up on unpaid insurance claims after denial to obtain settlement of claim.


• Audit insurance and patient accounts to determine whether a refund is needed.


• Promptly and courteously responds to all inquiries received from payors and patients either by telephone or written request.


• Provides clear communication and customer service on collection issues to external customers and internal business partners.


• Helps patients develop patient payment plans.


• Identifies patterns and trends that indicate a potential issue.


• Adheres to all policies and procedures in performing job duties and responsibilities while supporting a culture of high quality and great customer service.


• Performs other duties that may be necessary or in the best interest of the organization.


• Submits billing data to insurance providers.


• Participates in continuing educational activities relative to assigned duties and responsibilities.

Qualifications

Qualifications/Skills:

• High school diploma or GED required.


• Computer proficiency and experience in windows-based technologies


• Ability to be discrete and security confidential and sensitive information.


• Prior work experience in a medical office setting preferred.


• Excellent problem-solving skills, attention to detail, management of multiple tasks and the ability to do so independently.


• Ability to handle difficult situations with a positive attitude.


• Good interpersonal, oral and written communication skills.


• Strong organizational and time management skills.


• Ability to adhere to deadlines timely.


• Must be able to work as part of a team with peers and leadership within the organization.


• Must possess a high level of interpersonal skills including the ability to respond calmly and make rational decisions in stressful situations.