Hybrid COLLECTIONS SPECIALIST en ORTHOPAEDIC ASSOCIATES OF WISCONSIN

Description

The Collections Specialist is responsible for ensuring timely reimbursement by managing patient accounts, following up on outstanding balances, and addressing claim denials or billing discrepancies. This role requires strong communication skills to work with patients and internal staff while maintaining compliance with healthcare regulations. By monitoring aging reports, arranging payment plans, and accurately documenting all collection activities, the specialist helps optimize cash flow and support the financial health of the practice.

Requirements

Key Responsibilities

• Monitor and manage patient accounts to ensure timely collection of outstanding balances
• Communicate professionally with patients, insurance companies, and internal staff to resolve billing discrepancies and establish payment arrangements.
• Review aging reports and follow up on delinquent accounts to minimize bad debt and maximize cash flow.
• Maintain accurate documentation of all collection activities while adhering to HIPAA regulations and healthcare compliance standards.
• Collaborate with the billing department and staff to address coding, authorization, or claim denial issues affecting reimbursement or payments
• Interface with 3rd party collection agency as needed
• Keeping detailed records of all collection efforts, including contacts, agreements, and resolutions. 
• Providing regular updates to management on collection progress, challenges, and results. 
• Completes special projects as assigned.

An individual in this position must be able to perform the essential duties and responsibilities listed above successfully. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions of this position.

The above list reflects the general details necessary to describe the principle and essential functions of the position and shall not be construed as the only duties that may be assigned for the position.

Minimum Qualifications

Education

• High School Diploma or equivalent

Required

• Three or more years of experience in healthcare collections 
• Experience using EPIC, Microsoft Office, and Payer Portal.
• Must be able to maintain a professional attitude and confidentiality.
• Strong oral and written communication, and time management skills
• Ability to work in a team environment
• Ability to multitask in a high volume, fast paced working environment. 

Preferred

• Familiarity with commercial insurance guidelines and medical terminology
• Background in healthcare is a plus!

Physical and Mental Demands

Communication Skills

Ability to clearly explain billing procedures, insurance details, and payment options to patients, as well as effectively communicate with healthcare providers and insurance companies. Accurate documentation of billing information and patient interactions. Strong interpersonal skills to handle patient inquiries and resolve billing issues in a professional and empathetic manner.

Mathematical Skills

Proficiency in basic math operations for calculating charges, payments, and adjustments. Understanding of billing cycles, insurance reimbursement rates, and payment plans. Ability to perform reconciliations and handle financial discrepancies. Ability to analyze billing data, identify trends, and detect errors or inconsistencies. 

Judgement and Decision Making

Ability to identify billing issues, investigate causes, and implement solutions. Prioritizing tasks based on urgency and importance. Evaluating complex billing situations, making informed decisions, and considering the potential impact on patients and the clinics. Ensuring all billing practices comply with legal and regulatory standards, maintaining patient confidentiality, and handling sensitive information responsibly. Ability to work under pressure, meet deadlines, and handle multiple tasks simultaneously.