Surgical Collections Specialist - Remote

Surgical Collections Specialist - Alliance Health System

As a Surgical Collections Specialist, you will play a crucial role in ensuring the financial health of our organization by managing and optimizing the accounts receivable process specifically for our surgical claims. You will work closely with healthcare providers, insurance companies, and internal departments to maximize revenue and minimize outstanding balances. This position requires attention to detail, strong analytical skills, and a deep understanding of medical billing and reimbursement processes.

Responsibilities

• Denial Management: Investigate and resolve claim denials by appealing, resubmitting, or making necessary corrections.

• Follow-Up: Conduct regular follow-ups with insurance companies and patients to ensure timely payment of outstanding balances.

• Compliance: Stay updated on industry regulations and compliance requirements to ensure adherence in billing practices.

Basic Requirements

• Claim Resolution and Reimbursement: Demonstrate strong desire and commitment to resolving medical claims and effectively collecting insurance reimbursements.

• Organizational Skills: Must possess excellent organizational skills with thorough attention to detail in handling accounts receivable processes.
• Independence and Collaboration: Ability to work independently and collaboratively within a group, fostering a team-oriented and efficient work environment.

• Communication Skills: Exceptional written and verbal communication skills are essential, showcasing the ability to interact professionally and effectively with both internal and external stakeholders.

Experience Requirements

• Medical Billing/Collections Professional: Proven experience in resolving denied/underpaid claims and conducting thorough follow-ups with insurance providers to maximize reimbursements.

• Diverse Responsibilities: Extensive experience in various aspects of medical billing and collections, including but not limited to claim submissions, attorney follow-ups, and other duties relevant to the field.
• Specialized Expertise: Prior experience in surgical setting including Pain Management, Orthopedic, and Vascular disciplines.
• Excel/Google Sheets: Demonstrated proficiency in utilizing Excel and Google Sheets for data analysis and reporting purposes.
• Out of Network Experience: Proven track record of handling Out of Network billing processes effectively.
• Payer Portals: Familiarity with various Payer Portals for streamlined communication and efficient claims processing.
• Insurance Knowledge: Extensive experience with all Major Medical Insurance Providers, Work Comp, and Motor Vehicle claims is preferred.

• Bilingual Skills: Fluency in Spanish is a plus.

Background Check Requirement: Employment is contingent upon the successful completion of a background check, which may include verification of employment history, education, criminal records, and other relevant information as permitted by law