Medical Collections Specialist

Job Description

Job Description

Medical Collections Specialist

POSITION SUMMARY:

The Medical Collections Specialist is responsible for managing outstanding patient account balances by contacting patients, coordinating with insurance carriers, resolving billing concerns, establishing payment arrangements, and ensuring timely collection of accounts receivable. This position serves as a resource for patients and partners while supporting the organization’s financial goals through effective account resolution. The position reports directly to the Director of Billing Operations.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Contact patients regarding outstanding account balances through outbound and inbound phone calls, letters, text messages, and other approved communication methods.

• Review patient accounts to determine outstanding balances, insurance payments, and billing history.

• Explain medical transportation charges, insurance payments, deductibles, coinsurance, and patient financial responsibility.

• Establish payment plans in accordance with company policies.

• Process credit card, ACH, and other approved payment methods.

• Proactively contact patients and insurance companies to resolve low reimbursement claims, coordinate claim corrections and reprocessing, and reduce outstanding patient balances while ensuring accurate reimbursement.

PERFORMANCE EXPECTATIONS:

• Document all patient communications and collection efforts accurately within the billing system.

• Follow up on delinquent accounts according to established collection timelines.

• Identify accounts requiring financial assistance review or referral to outside collection agencies.

• Research and resolve patient billing questions and disputes.

• Maintain confidentiality of all patient information in accordance with HIPAA regulations.

• Comply with all applicable federal and state debt collection laws and company policies.

• Meet individual productivity and collection performance goals.

• Performs all activities in accordance with company standards:

Company Standards

• Performs all duties in a safe, courteous, confidential and professional manner.

• Maintains a positive and professional image by being well groomed and properly attired at all times.

• Mentors, trains, and encourages fellow staff as needed, to help them attain their full potential.

• Completes all reports legibly, accurately, and on a timely basis.

• Maintains confidentiality of all customer and Armstrong information.

PATIENT PRIVACY:

• Employees are expected to protect the privacy of all patient information in accordance with Company policies, procedures, and practices, as required by Law, and in accordance with general principles of professionalism as a health care provider.

• Employees may access protected health information and other patient information only to the extent that it is necessary to complete job duties and may only share such information with those who have a need to know specific patient information to complete their job responsibilities related to treatment, payment, or other company operations.

• Employees are encouraged and expected to report, without the threat of retaliation, any concerns regarding the company’s policies and procedures on patient privacy and any observed practices in violation of that policy to the designated management personnel.

QUALIFICATIONS:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements below are representative of the knowledge, skill, and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

• High school diploma or equivalent required.

• Associate’s degree preferred.

• Minimum of 2 years of medical billing or collections experience preferred.

• Knowledge of healthcare billing, insurance, Medicare, Medicaid, and commercial insurance.

• Legal experience a plus.

• Experience with patient collections and payment negotiations preferred.

• Strong verbal communication and conflict resolution skills.

• Excellent organizational and time-management abilities.

• Proficiency with Microsoft Office and electronic billing systems.

• Ability to maintain professionalism and empathy during difficult conversations.

Knowledge, Skills and Abilities:

• Strong customer service orientation

• Ability to communicate financial information clearly and respectfully

• Excellent negotiation and problem-solving skills

• Ability to work independently while managing multiple priorities

• Strong attention to detail

• Ability to maintain confidentiality and professionalism

PHYSICAL REQUIREMENTS:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. The employee must:

• Prolonged periods of sitting.

• Frequent use of computers and telephones.

• Ability to lift up to 20 pounds occasionally.

WORK ENVIRONMENT:

This position is primarily performed in an office setting with extensive telephone and computer use.