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A/R Specialist, Collector at USPI
Courtry, Ile-de-France, France -
Full Time

Start Date

Immediate

Expiry Date

03 Jul, 26

Salary

0.0

Posted On

04 Apr, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

No

Skills

Medical collections, Accounts receivables, Insurance billing, Denial processing, Appeal submission, EOB review, Medical documentation, Medicare, Medicaid, LCDs, Microsoft Office, Excel, Outlook, Advantx, Vision, Waystar

Industry

Hospitals and Health Care

Description
Position Overview: Reporting to the Client Operations Manager, the Revenue Cycle Specialist - Collector must have a strong knowledge of medical collections, accounts receivables, insurance billing and verification, denial processing, appeal submission and EOB review. This position is responsible to resolve outstanding surgical claims resulting in maximum reimbursement. Responsibilities: * Timely follow-up and resolution on all outstanding A/R including unpaid/underpaid/denied claims for all payers including self-pay to obtain maximum reimbursement. * Manage daily work queue to prioritize high dollar claim balances. * Review & work incoming insurance and patient correspondence including refund requests. * Send appeals when appropriate or provide the requested medical documentation. * Ability to review medical documentation to justify medical necessity. * Review patient balances to ensure accuracy and follow up with patients to obtain payments. * Take incoming patient phone calls to resolve inquiries, billing issues, or outstanding balances. * Review insurance payments and determine accuracy of reimbursement based on contracts, fee schedules or summary plan documents. * Leverage knowledge of Medicare, state Medicaid, and local coverage determinations (LCD’s) for claim resolution. * Negotiate payment amounts for procedures with Third Party Administrators for out of network providers. * Recommend an adjustment when applicable or recommend a refund for overpayments to insurance carriers or patients, providing the appropriate documentation.
Responsibilities
The Revenue Cycle Specialist is responsible for resolving outstanding surgical claims, managing work queues, and ensuring maximum reimbursement. They will handle insurance and patient correspondence, process appeals, and negotiate payment amounts with third-party administrators.