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U
USPI
Collections Specialist
Career Insights for Claims Representative
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Based on Georgia data
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What they do
A Claims Representative accepts and reviews applications for insurance and provides information to insurance agents. Assists insurance customers, answers questions and processes requests to change or cancel policies. May assist with insurance claims that are disputed, review claims and policy coverage and help to negotiate agreements between customers and an insurance company.
$52,435 / year median in Georgia
+6% projected growth
Job Description
Collection Specialist Orthopaedic South Surgical Center is seeking a Collection Specialist, Part time a Temporary 6 month position. Orthopaedic South Surgical Center performs a broad range of outpatient surgical procedures. Our mission is to care for every patient and their family as if they were our own. Each patient, each family, each and every time. We are seek a Meticulous and quality and high-safety principled professional needed for single specialty ortho practice. We are looking for a motivated performer to join our Business Office team as a Collections Specialist, with an extensive knowledge of claims reimbursement and collection efforts for Managed Care, Medicare, Medicaid, Workers Comp, Commercial plans, etc. We are looking for a top performer with an extensive knowledge of billing, collections and reimbursement of claims processing. This is a fast paced environment committed to producing the highest quality work for our surgery center. An ideal candidate will be personable and courteous. We are looking for a competent Collection Specialist to contact clients and collect outstanding payments. You will struck a balance between maintaining trustful relationships, and ensuring timely payments. Our Collection Specialist should exhibit professionalism and trustworthiness. You should have excellent communication and negotiation skills, as well as an ability to work independently and interdependently with other business office staff. Job Summary Under the direction of the Business Office Manager, the Collections Specialist is responsible for follow up on delinquent surgery center claims), working an expected number of claims per day. Majority of claims will have been submitted to various insurance carriers electronically. Knowledge of how to interpret a managed care contract, Medicare and Medicaid and Workers Compensation claims is a must. You will be given tools to calculate allowable and required to determine appropriateness of reimbursement and appeal claims as necessary. Extensive contact with insurance carriers of all types, as well as communication with patients regarding out of pocket amounts is required. Identification of accounts that have been either under or over paid, issuing credit balance information either to the insurance carrier or the patient. All of these practices done in a professional and communicative manner, per policies and procedures, guidelines, internal control measures and established goals. . Candidate must be a team player, and have ability to communicate well with direct reports, patients, customers, insurance carriers, etc. Ability to manage accounts worked independently, and in a productive manner. Must project a professional demeanor and appearance while maintaining the confidentiality of the surgery center and patients. Works well in stressful environment and in situations that demand patience. Projects a professional demeanor and appearance while maintaining the confidentiality of administration, patients, physicians and employees. Works under stress and in situations that demand patience and tact while providing impeccable service.