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Collections Specialist

Oceans Healthcare

The Collector is responsible for accurate and timely billing and collection of outstanding receivables from third-party payers and payer representatives. The role maintains accurate account balances in accordance with contractual obligations, fee schedules, and applicable regulations.

  • Reviews third-party claims for accuracy and completeness using patient accounting systems and submits claims within timely filing restrictions.
  • Performs follow-up activities by telephone or electronic inquiry on accounts with outstanding balances.
  • Resolves issues that may delay claim adjudication and involves the patient or guarantor as needed.
  • Documents follow-up activity clearly and concisely in the patient accounting system.
  • Resubmits claims to payers as necessary, including secondary or tertiary plan claims.
  • Ensures accurate account balances for proper processing and reporting, including contractual allowances, adjustments, and balance transfers.
  • Coordinates with revenue cycle staff, Utilization Review/Case Management, and site leadership to support timely and accurate claims payment.
  • Researches and resolves credit balance accounts identified by payers or aging reports.
  • Completes daily and weekly productivity and performance reporting.
  • Performs other duties and projects as assigned.

The work environment is fast-paced, can be stressful, and involves frequent interruptions and multiple calls or inquiries.

Requirements & Qualifications
  • High school diploma or equivalent required.
  • Previous experience interpreting insurance plan benefits, conditions of payment, and billing requirements.
  • Previous customer service experience in a similar field is beneficial.
  • Experience with Microsoft Office products and general patient accounting systems.
  • Knowledge of third-party payers, Medicare, Medicaid, and other payer requirements.
  • Effective communication skills for phone contacts with insurance payers.
  • Strong customer service skills for interacting with patients and family members.
  • Ability to work in a team environment and with minimal supervision.
  • Strong understanding of confidentiality and compliance with applicable federal and state regulations.

Location

Louisiana, US

Employment Type

Full-time

Experience Level

Entry Level

Remote work allowed

No

Posted

4 weeks ago

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