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Medical Collections Specialist

Monroeville, PA

At this time, we are searching for a full-time Medical Collections Specialist. The Medical Collections Specialist provides clerical, billing and collection support for the company. This position is responsible for ensuring accurate and timely billing by monitoring and resolving issues related to claims denials, non-payment, over-payments and underpayments.

This position will be located in Blairsville, PA before transitioning to Monroeville, PA.

Essential Functions

  • Utilize various Accounts Receivable reports/tools to target aged balances for collection.
  • Denial Management: investigate reasons for denials; utilize denial management strategies and appeal denials, when applicable.
  • Ensure appeal submission guidelines are in adherence with payer requirements.
  • Monitor the timely filing of claims and appeals.
  • Document patient collections activity in EMR software.
  • Fiscal Accountability: follow departmental processes to obtain maximum reimbursement for services and successful flow of the revenue cycle.
  • Alert management to irregularities, payer trends, and areas of concern.
  • Identify errors in registration, eligibility verification, charge-entry, and/or payment posting, correct errors and provide feedback to appropriate staff.
  • Work with insurance payers on policies and regulations surrounding claims processing.
  • Meet or exceed key performance indicators measuring productivity, quality, and service levels, as defined by Management.
  • Actively participate in team initiatives and in team status meetings.
  • Complete other duties and tasks as assigned.

Qualifications and Skills

  • High School Diploma or equivalent; post-secondary education a plus.
  • Minimum of 2 to 4 years of healthcare related experience in billing and collections.
  • Knowledge of physical therapy billing and CPT codes preferred.
  • Knowledge with CMS 1500 and UB04 Billing Forms, EOBs, claims, coding and charges is required.
  • Demonstrated knowledge of third-party and insurance companies’ operating procedures, regulations and billing requirements; i.e. Commercial, Medicare, Medicaid, etc.
  • Insurance eligibility and benefit verification.
  • Ability to read and understand the information provided on EOB’s, remittance advices, and other insurance correspondence.
  • Excellent verbal and written communication skills
  • Effective customer service skills with the ability to interact with both internal and external customers, i.e. patients, insurance payors, Patient Care Coordinators and therapists in a professional manner.
  • Ability to prioritize work, handling daily and multiple tasks to completion within the time allotted, while working as part of a team within a demanding environment.
  • Knowledge of medical terminology and ICD-10 beneficial.
  • Proficiency with Microsoft Office tools with a sharp technical aptitude.
  • Ability to work independently with minimal supervision.

PHOENIX offers a competitive salary and benefit package that includes PTO, holidays, optional participation in medical, dental, and vision coverage, life and disability insurance, and 401(k).  All interested candidates should submit their resumes to Erin McKinney – Associate Director of Billing at emckinney@phoenixrehab.com

PHOENIX is an E-Verify and Equal Opportunity Employer.

Submit Your Resume