Altus Community Healthcare
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Collections Specialist
role at
Altus Community Healthcare . Position Summary:
The Collections Specialist is responsible for timely and accurate claims filing, review, and resolution of denied insurance claims. The role involves reviewing billing information such as provider medical records, billed claims, insurance carrier explanation of benefits, denial letters, and electronic remits to ensure prompt payment processing, denial management, and appropriate appeals. Essential Duties and Responsibilities: Monitor open claims, appeal deadlines, and collection efforts daily, ensuring workflow adherence. Review and follow up on payer denials, rejected claims, and appeals promptly. Research and resolve payment issues, identify denial trends, and escalate as needed. Track incoming correspondence and schedule negotiations and mediations. Manage weekly invoicing and ensure timely payments. Conduct workflow audits and identify training needs. Prepare for and conduct mediations, reporting trends and process improvements. Provide education and training as required. Ensure compliance with healthcare laws and regulations. Perform additional duties as assigned. Education and Experience: Extensive experience in collections, denials management, NSA, IDR, TDI, and negotiations, preferably in a free-standing emergency room setting. Deep knowledge of healthcare regulations, privacy laws, and billing standards. Strong billing and coding skills, with a preference for emergency room experience. Excellent communication and interpersonal skills. Ability to analyze data, identify trends, and make data-driven decisions. Proficiency in healthcare information systems and patient access software. Experience in process improvement and implementing best practices. Physical Demands:
Vision, hearing, repetitive motion, light physical activity, including ascending stairs, bending, and wrist movements. Work Environment:
Well-lit, climate-controlled indoor office with adequate ventilation. Seniority level
Associate Employment type
Full-time Job function
Health Care Provider Industries
IT Services and IT Consulting
#J-18808-Ljbffr
Collections Specialist
role at
Altus Community Healthcare . Position Summary:
The Collections Specialist is responsible for timely and accurate claims filing, review, and resolution of denied insurance claims. The role involves reviewing billing information such as provider medical records, billed claims, insurance carrier explanation of benefits, denial letters, and electronic remits to ensure prompt payment processing, denial management, and appropriate appeals. Essential Duties and Responsibilities: Monitor open claims, appeal deadlines, and collection efforts daily, ensuring workflow adherence. Review and follow up on payer denials, rejected claims, and appeals promptly. Research and resolve payment issues, identify denial trends, and escalate as needed. Track incoming correspondence and schedule negotiations and mediations. Manage weekly invoicing and ensure timely payments. Conduct workflow audits and identify training needs. Prepare for and conduct mediations, reporting trends and process improvements. Provide education and training as required. Ensure compliance with healthcare laws and regulations. Perform additional duties as assigned. Education and Experience: Extensive experience in collections, denials management, NSA, IDR, TDI, and negotiations, preferably in a free-standing emergency room setting. Deep knowledge of healthcare regulations, privacy laws, and billing standards. Strong billing and coding skills, with a preference for emergency room experience. Excellent communication and interpersonal skills. Ability to analyze data, identify trends, and make data-driven decisions. Proficiency in healthcare information systems and patient access software. Experience in process improvement and implementing best practices. Physical Demands:
Vision, hearing, repetitive motion, light physical activity, including ascending stairs, bending, and wrist movements. Work Environment:
Well-lit, climate-controlled indoor office with adequate ventilation. Seniority level
Associate Employment type
Full-time Job function
Health Care Provider Industries
IT Services and IT Consulting
#J-18808-Ljbffr