Under the direction of the Business Office Manager, the Collections Specialist is responsible for follow up on delinquent surgery center claims), working an expected number of claims per day. Majority of claims will have been submitted to various insurance carriers electronically. Knowledge of how to interpret a managed care contract, Medicare and Medicaid and Workers Compensation claims is a must. You will be given tools to calculate allowable and required to determine appropriateness of reimbursement and appeal claims as necessary.
Extensive contact with insurance carriers of all types, as well as communication with patients regarding out of pocket amounts is required. Identification of accounts that have been either under or over paid, issuing credit balance information either to the insurance carrier or the patient. All of these practices done in a professional and communicative manner, per policies and procedures, guidelines, internal control measures and established goals. .
Candidate must be a team player, and have ability to communicate well with direct reports, patients, customers, insurance carriers, etc. Ability to manage accounts worked independently, and in a productive manner. Must project a professional demeanor and appearance while maintaining the confidentiality of the surgery center and patients. Works well in stressful environment and in situations that demand patience.
Projects a professional demeanor and appearance while maintaining the confidentiality of administration, patients, physicians and employees. Works under stress and in situations that demand patience and tact while providing impeccable service.
Shift: Day
Hours: Monday – Friday 8 a.m. to 5 p.m.
EDUCATION, TRAINING AND EXPERIENCE REQUIREMENTS:
2-3 years previous collections experience, with emphasis on healthcare insurance collections of all types. Preference shown to previous experience in an ambulatory surgical setting.
Medical terminology.
Prefer previous experience working with Advantx. (Patient Accounting System)
Ability to work independently.
Excellent communication skills and interpersonal skills.
Skilled in time management and prioritization of emergent situations.
Good customer service skills, always demonstrates professionalism.
Comfortable utilizing critical thinking skills.
Typing 45-60 WPM.
High School Diploma or equivalency.
Proficient with Microsoft Office products.
Experience with electronic patient information systems.
Prefer previous experience with Electronic Health Record system but will train.
Strength in Numbers
United Surgical Partners International (USPI) and Tenet have combined forces to create the nation’s largest ambulatory surgery provider. Our combined network of exceptional surgical and imaging facilities includes approximately 20 imaging centers, and over 265 short-stay surgical facilities. Together, our partnerships include 50 health systems and more than 4,000 physicians.
Nationwide Experience
Our partners deliver high quality ambulatory solutions in safe, efficient and caring USPI facilities in communities of every size across 29 states. Our physician partners are focused on providing quality patient care, in part because they are invested in their USPI facility. We provide the infrastructure and support they need to perform their best. This is one of the advantages of partnering with USPI.
Quality Patient Services
We share a vision with our physician and health system partners. Our goal is to provide the quality of healthcare services we would insist upon for our own families. Since our founding in 1998, this goal has helped us grow exponentially. Today, our strategic joint venture with Tenet establishes USPI as one of the nation's leading providers of ambulatory solutions.
Operating Excellence
Our size and experience in developing and operating ambulatory facilities and strategic vision allow our facilities to achieve both high patient satisfaction and solid financial results. Moreover, because we engage physicians in the governance and growth of the facility, we also achieve excellent clinical outcomes.