Collection Specialist Position Summary: The Collector Specialist supports the collections department by performing daily tasks related to insurance follow-up, patient collections, denial resolution, and accounts receivable (A/R) management. This entry-level role contributes to reducing days in A/R, minimizing denials, improving collection rates, and supporting optimal cash flow for healthcare providers. The position requires strong attention to detail, persistence, organizational skills, and a team-oriented approach while learning industry processes and payer requirements.
Key Responsibilities
· Perform insurance follow-up on outstanding claims, including contacting payers to check claim status, resolve unpaid or underpaid accounts, and request additional information as needed.
· Assist with patient collections by making outbound calls, sending statements, and following up on self-pay balances while maintaining professionalism and empathy.
· Review and work aging A/R reports under guidance, prioritizing accounts based on age, dollar amount, and payer type to ensure timely resolution.
· Support denial management by identifying basic denial reasons, preparing simple appeals or resubmissions, and documenting corrections in the billing system.
· Direct adjustments, and denials accurately to patient accounts and reconcile as directed.
· Respond to patient and payer inquiries regarding bills, insurance coverage, and account status in a timely and courteous manner.
· Collaborate with team members and other departments (e.g., billing, coding, or registration) to gather information needed to resolve accounts.
· Maintain accurate documentation of all collection activities, communications, and account notes in the revenue cycle system.
· Adhere to healthcare regulations (HIPAA, CMS guidelines, payer contracts) and internal policies to ensure compliance and patient confidentiality.
· Participate in training sessions to learn payer policies, billing systems, and best practices in medical collections.
· Assist with basic quality assurance tasks, such as reviewing own work for accuracy under supervision.
· Track personal productivity metrics and contribute to team goals for collections and A/R resolution.
Required Knowledge, Skills, and Abilities
· Basic understanding of medical billing, insurance claims processing, and collections workflows (training provided).
· Familiarity with major payers (e.g., Medicare, Medicaid, commercial insurers) and common reimbursement processes is a plus but not required.
· Strong attention to detail, organizational skills, and ability to prioritize tasks in a fast-paced environment.
· Good verbal and written communication skills for interacting with patients, payers, and team members.
· Customer service orientation with professionalism, especially when discussing sensitive financial matters.
· Proficiency with computers, including Microsoft Office and willingness to learn revenue cycle management systems and reporting tools.
· Ability to follow instructions, work independently on routine tasks, and escalate complex issues appropriately.
· Commitment to confidentiality, regulatory compliance, and ethical standards.
Education, Experience, and Requirements
· High School Diploma or equivalent required; additional education or certifications in medical billing/collections.
· 3+ years of experience in medical billing, collections, customer service, or a related healthcare/revenue cycle role; preferably in specialty infusion therapy or complex outpatient services.
· Entry-level candidates welcome with strong willingness to learn.
· Must meet U.S. employment eligibility requirements