Receivable Collections Specialist

Local Health Care Company is searching for a AR collection specialist who will assist in all aspects of AR collections including submitting corrected claims, appeals, or facilitating the reprocessing of denied, low-paid, or unprocessed claims. The AR specialist will utilize excel spreadsheets to identify aging AR unpaid claims. Candidates with a minimum of 2 yrs of Healthcare experience in AR and or a Healthcare Administration Certificate, or Bachelor Degree should submit their resume.

Responsibilities

• Comply with all applicable CHC Solutions policies, procedures, and patient protocols.
• Comply with all current government regulations and professional standards, including HIPAA, the fair debt collection act and voluntary compliance plans.
• Maintain high level of professionalism and dedication to excellent customer service during all communications with payers, customers, vendors, and CHC Solutions employees.
• Review underpaid claims; Identify accuracy of payments per payer contracts/fee schedules. Apply appropriate write off code to balances of accurately paid claims for adjustment. Notify team lead of pricing discrepancies in Fastrack PMS.
• Utilize Fastrack, Claims Clearinghouse Waystar and payer specific websites to correct claim errors in response to rejected claims.
• Identify claims that have not been processed by the payer. Verify correct filing and resubmit claims that have not been processed by insurance company.
• Contact patient, physician office, and internal resources to obtain information and documentation to facilitate collection of claims.
• Identify claims that cannot be reimbursed and apply appropriate write off request codes.
• Follow up on outstanding AR that has not been processed for full payment until the claim is resolved.
• Utilize collections expertise to identify and escalate payer issues.
• Write appeals to insurance companies to overturn denied or short paid claims.
• Answer incoming patient pay/billing phone calls. Respond to all phone calls and billing inquires in accordance with the fair-debt collections act and HIPAA guidelines.
• Maintain professional communication with other departments as appropriate.

Qualifications and Skills

• One-year healthcare AR experience or equivalent education
• DME experience preferred
• Microsoft Office software
• Strong analytical and problem-solving skills
• Detail oriented
• High School Diploma or equivalent
• Healthcare Administration Certificate, Bachelor’s degree or 2 years minimum work experience

Benefits/Compensation

• Pay rate is $18-$23 per hour
• Full Time
• 1st Shift: 8:30 am- 5 pm. M-F
• Weekly pay while employed through Career Concepts.
• Benefits while employed through Career Concepts
• Temp-To-Hire

Location

• Pittsburgh, PA 15275

About Career Concepts Staffing Services, Inc.

Career Concepts was founded in 1967, and since then has become Northwestern Pennsylvania's leading and largest locally owned full-service staffing organization. As the top industry performer in our area, we have been voted the #1 employment agency by the Erie Times-News, the Meadville Tribune, and the West County Journal Reader’s Choice polls!