Collections Specialist- substance abuse

POSITION SUMMARY

Looking for a Collections Specialist with extensive experience in resolving unpaid claims. Candidate must possess knowledge of claims reimbursement and collection efforts for Commercial plans. In addition to following up on claims, candidate will be responsible for sending out medical records and writing appeals for denials to the insurance companies. Candidate must be detail oriented and motivated in getting claims paid. This is a fast paced environment committed to producing the highest quality of work, therefore candidate must be self-motivated and able to take leadership of their work.

GENERAL REQUIREMENTS/QUALIFICATIONS

Responsibilities and Duties

• Use EMR and Billing Software to review patient chart and claims.
• Work from Aging Report making calls to insurance companies for claim status and resolution
• Candidate must have experience in healthcare collections (denials, negotiations, appeals, etc.); substance abuse experience is preferred but not required
• Candidate must have a full understanding of insurance language (i.e. deductibles, out-of-pocket expenses, in-network vs. out-of-network, etc.)
• Strong attention to detail
• Enter all notes in Billing Software CMD
• Problem Solving skills
• Verify patient Eligibility and Benefits
• Exceed productivity and quality goals for all open A/R
• Work with Billing Manager and other team members to resolve all Open issues
• Track and report all trends and issues that delay claims resolution

Qualifications and Skills

· Knowledge in Substance Abuse and Medical Insurance field

· Experience with pre- payment audits with different payers requiring medical records review

· Experience in collecting outstanding balances

· Strong computer skills including the knowledge of Microsoft Office and Insurance provider portals

• Must have comprehension of 150's, UB 04

· Must be extremely organized, task oriented, and motivated

· Must have experience with Collaborate MD, and KIPU

· Must possess excellent communication skills with management and be a team player

· Ability to work independently and to adapt to a fast changing environment

MINIMUM EDUCATION AND LICENSURE/CERTIFICATION:

· Associated/Bachelor degree Preferred

· Ability to organize and prioritize work.

· Proficient with, MS Office applications including Word, Excel, and Outlook.

· Valid Driver’s license.

REQUIRED QUALIFICATIONS

· Substance Abuse Billing and Collections: 4 years (Preferred)

· Medical Billing and Coding: 4 years (Preferred)

Benefit Conditions:

• Waiting period may apply
• Only full-time employees eligible

This Company Describes Its Culture as:

• Detail-oriented -- quality and precision-focused
• Aggressive -- competitive and growth-oriented
• Outcome-oriented -- results-focused with strong performance culture

Paid Training:

• Yes

Typical end time:

• 5PM

Typical start time:

• 8AM

Work Remotely

• No

This Job Is Ideal for Someone Who Is:

• Dependable -- more reliable than spontaneous
• People-oriented -- enjoys interacting with people and working on group projects
• Detail-oriented -- would rather focus on the details of work than the bigger picture

Job Type: Full-time

Pay: $18.38 - $27.00 per hour

Expected hours: 40 per week

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• Monday to Friday

Work Location: Hybrid remote in Port Saint Lucie, FL 34985