Collection Specialist

Greetings,

I hope this email finds you well. My name is Pradeep Singh from SDK Software Inc/ Siri InfoSolutions Inc. I came across your profile in our internal database/job boards, and based on your experience, I believe you could be an excellent fit for the following position with one of our clients. If you are interested and looking for a new job, please reply with your updated resume. I'd be glad to schedule a quick call to discuss further.

Working Title: Collection Specialist

Location: San Leandro CA

Schedule: 7:00 am - 3:30 pm includes a 30 min break

Duration: 6 months with possibility of extension

Job Description:

Candidates Requested

Preferred - 3-5 years of experience in a hospital business environment performing billing and/or collections. No certification requirement however someone with a strong background in collection and patient accounting (medical billing). EPIC back-end experience is a must.

Job Summary:

The PFS Collection Specialist is responsible for all aspects reviewing payer contracts, claims and performing third party collection activity for hospital services.

Qualifications:

Required Education:

• High school diploma or equivalent education.
• Minimum Experience: One year of experience in a Revenue Cycle area within the Alameda Health System; OR the equivalent of two years' experience, performing medical billing/collections or medical accounts receivable functions in a healthcare insurance related environment.
• Any combination of education and experience that would likely provide the required knowledge, skills and abilities as well as possession of any required licenses or certifications is qualifying.

Knowledge, Skills & Abilities:

• To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
• Good written and verbal communication skills.
• Intermediate computer skills including thorough understanding of the EHR system, Microsoft Office (Word, Outlook, Excel, PowerPoint).
• Intermediate knowledge of UB-04 and Explanation of Benefits (EOB) interpretation.
• Intermediate knowledge of CPT and ICD-10 codes.
• Intermediate knowledge of insurance claims and insurance terminology.
• Act in an appropriate and professional manner as defined by the company's Standards of Behavior, Policy and Procedures, and Scope of Services.
• Role model AHS Standards of Behavior.
• Current office administrative practices and procedures.
• Correct business English, including spelling, grammar and punctuation.
• Use independent judgment and initiative within established policies and procedures.
• Establish and maintain effective working relationships with a variety of individuals from various socioeconomic, ethnic and cultural backgrounds.
• Should have a good understanding of payer contract language, and how to apply language to reimbursements.
• Excellent communication skills, both written and verbal.

Job Responsibilities:

• Responsible for all aspects of follow up and collections on insurance balances, including making telephone calls, accessing payer websites. Identify issues or trending and provide suggestions for resolution. Accurately and thoroughly documents the pertinent collection activity performed. Review the account information and necessary system applications to determine the next appropriate work activity. Verify claims adjudication utilizing appropriate resources and applications. Initiate telephone or letter contact to patients to obtain additional information as needed. Perform appropriate follow-up functions, including manual re-submissions as well as electronic attachments to payers. Manage and maintain desk inventory, complete reports, and resolve high priority and aged inventory.
• Participate and attend meetings, training seminars and in-services to develop job knowledge. Participate in the monthly, quarterly and annual performance evaluation process with Supervisor. Respond timely to emails and telephone messages as appropriate. Communicate issues to management, including payer, system or escalated account issues.
• Maintains information or operational records; screens reports for completeness and mathematical accuracy; list, abstracts, or summarizes data; compiles routine report from a variety of sources.
• May, as a secondary responsibility, interpret abstracts, orders, notes, invoices, permits, licenses, etc.; computes and receives fees when the amount is not in question or is readily obtainable from fixed schedules; posts data; and prepares reports in accordance with pre-determined forms and procedures.
• Prepares documents for collection of revenues from third party payer programs; checks and verifies charge rates for services; reconciles account balances and verifies payments.
• Reviews billing documents to assure program compliance for Medicare, Medi-Cal, Mental Health, and insurance programs; assures that all appropriate medical documentation is submitted timely. Other duties as assigned.

Vaccinations process : Health Screen(while on boarding process)

In case the client extends an offer, you have to take care of the below health screen process and we will take care of the drug test and background check.

1. Need immunization records for MMR and varicella Mumps, Measles & Rubella and Varicella) should be positive, if you have negative results in any of these then you have to take 2 MMR vaccinations with a gap of 28 days since you cannot take 2MMR vaccinations at a time.
2. For TB test you have other available options- TSPOT or QF TB Gold or 2 step PPD's for 2 step PPD's you need visit clinic twice and to get these results it may take more than 1 week and should provide latest documents 2019 valid within 3 months )
3. Physical Test- You can check with your doctor.
4. Vision Test
5. COVID Vaccinated

Thank you

/ candidates are encouraged to Apply

Regards,

Pradeep Singh

Senior Recruiter Healthcare & IT

SDK Software Inc (Siri InfoSolutions Group)

(D)

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