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The Collections Specialist plays a key role in ensuring optimal reimbursement by performing insurance collections. This role includes all aspects of revenue cycle collections including denial management, appeals and accounts receivable collections. This position will coordinate and collaborate with the Billing Specialists and ensure payer compliance across all platforms for the insurance billing guidelines in a timely manner through communication with Admissions, Client Experience, Authorizations team, and Operations. As a Collections Specialist, you are responsible for researching, disputing and appealing denied claims.

Duties/Responsibilities:

• Research and resolve insurance denials
• File appeals on denied or underpaid claims
• Maintain knowledge of payors' billing guidelines and health benefits
• Interpret remittance advice/explanation of benefits
• Identify denial trends
• Compile underpaid, incorrectly denied claims to submit to payor as payor project
• Attend and participate in meetings, trainings and in-services to develop job knowledge
• Work within the practice management system and clearinghouse to submit and
• reconcile claims
• Verify claim status for claims billed over 60 days through payor portals and or payor
• claims department
• Responsible for all aspects of follow up and collections, including making telephone
• calls, accessing payor websites, and verifying adjudication
• Verify correct insurance filing information
• Enter accurate notes for all activities
• Send Medical Records and other documentation to payors as requested
• Meet daily, monthly and quarterly billing metrics
• Other duties as assigned
• Perform all job duties according to department policies and procedures
• Provide extra resource when needed within the department (ie special projects or high[1]volume functions)
  
• Accountability

• Teamwork
  • Collaborates with other departments (client experience/ operations/authorizations/admissions/scheduling/billing) to improve efficiencies throughout the Acorn Health organization as it relates to Billing, Collections and payor participation
  • Efficient communication skills – Written and verbal

• Disciplined
  • Self-motivated and reliable
  • Able to stay focused on tasks and work independently in a remote setting
  • Perform overtime when needed

Knowledge, Skills & Abilities:

• Understanding of medical billing principles and practices
• Proficient in medical terminology, HIPAA and other critical governmental regulations
• Ability to comprehend various insurance documentation, analyze and reconcile accounts
• and follow detailed procedures in an organized and efficient manner
• Organized and detail-oriented
• Ability to multi-task and meet deadlines
• Excellent verbal and written communication skills in a virtual environment such as over
• the phone, email and video calls.
• Superior communication, problem-solving and follow-up skills
• Strong computer skills (Word, Excel, billing software)
• Experience with ABA/behavior analysis insurance billing
• Experience with Central Reach software
• Knowledge of Commercial Insurance and Government Payor guidelines
• Excellent interpersonal skills
• Ability to work in a professional, fast paced, and confidential capacity
• Results oriented with ability to act with sense of urgency to meet operation needs
• Self-motivated individual, capable of identifying and completing crucial tasks
• independently and with a sense of urgency.
• At least 1-2 years of previous clerical experience in a medical setting (behavioral health
• is a plus)

Education and Experience:

• Minimum of one (1) year of Billing or Collections experience in a healthcare environment
• Associates degree preferred - Combination of education and experience may be considered.

Physical Requirements:

• Remain in a stationary position: More than 2/3
• Traverse or move around work location: none
• Operate or use department specific equipment: More than 2/3
• Ascend/Descend equipment or ladder: none
• Constantly position self to accomplish the Essential Functions of the role: none
• Receive and communicate information and ideas for understanding: More than 2/3
• Transport, position, and/or exert force: none
  • Up to 10 pounds: none
  • Up to 25 pounds: none
  • Up to 50 pounds: none
  • Up to 100 pounds: none
  • More than 100 pounds: none

The above statements are intended to describe the general nature and level of work being performed by employees in this classification.

Acorn Health is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, age, genetic information, veteran status, disability or other legally protected characteristic.