Collection Specialist

Legacy Community Health • Houston, TX, United States • $200k - $250k / year • 1d ago

Be a part of driving healthy change in our communities

About the Position

Responsible for timely and accurate billing, monitoring and collections of Medicaid, Managed Medicaid payers, and private insurance payers. Must possess critical thinking skills and understanding of Medicaid Eligibility requirements and third party payer payment methods to prepare contractual adjustments correctly based on payer contracts or government regulations. Responsible to submit electronic and paper claims to Medicaid, Managed Medicaid payers, and private insurance payers, follow-up on submitted claims in accordance with payer and facility policies, research rejections and denials, document account activity, post adjustments and demonstrate proficiency with billing system to ensure all functionality is utilized for the utmost efficient processing of claims. Responsible to report billing and collection trends, problems and issues that result in delayed claim processing. Responsible to maintain current on all private and government payer billing regulations and policy.

Key Responsibilities

Performs follow up with Medicaid insurance companies on unpaid insurance accounts identified through aging reports.
Identifies trends, and carrier issues relating to billing and reimbursements. Reports findings to Team Lead and/or Manager.
Processes appeals online or via paper submission.
Works independently.
Processes billing calls and questions from patients and third party carriers.

Requirements

High School Diploma/GED
Minimum of two years of related experience in a business, medical or technical environment.
Experience working in a Federally Qualified Health Center preferred.
Experience in medical/dental collections preferred.
Previous experience in a medical office setting and/or experience with an Electronic Medical Record a plus.