Collections Specialist - Patient Financial Services HB

The Collections Specialist role supports Patient Financial Services by completing timely follow-up and collection actions for third-party patient accounts in line with applicable state and federal requirements, as well as hospital policies and procedures.

Key Responsibilities

• Reviews reports from insurance companies and government payers to determine whether claims may be resubmitted
• Resubmits accounts, bills patients, or applies appropriate write-offs as needed
• Files appeals for rejected services within established filing deadlines
• Performs follow-up on unpaid third-party accounts by telephone and/or tracer in accordance with hospital time frames and guidelines
• Prepares rebilling as necessary
• Reviews correspondence received from third-party carriers and responds prior to insurance company deadlines
• Requests medical records when required
• Reviews payments for accuracy and proper application to patient accounts
• Contacts insurance carriers when payment is less than quoted benefits to resolve responsibility for the remaining balance
• Calculates and recalculates contractual allowances and corrects amounts as necessary
• Corrects Managed Care discounts and employee discounts after recalculating discounts
• Documents all insurance activity in the applicable computer system
• Performs assigned duties in a manner that meets the population-specific and developmental needs of members served by the department
• Adapts assessment, treatment, and/or service methods to accommodate each member’s unique physical, psychosocial, cultural, age-specific, and other developmental needs

Required Qualifications

• Education: High School Diploma

Work Location

Alamogordo, NM (onsite)

Schedule

8:00 AM - 5:00 PM, Monday-Friday

Employment Type

Full Time