Job Description
Job Description
Job Description
Collections & Billing Specialist - Automotive Medical Claims
Southfield, Michigan
We are hiring a Collections & Billing Specialist for auto-related medical claims who can aggressively and successfully focus on recovering payments for healthcare services provided to individuals injured in motor vehicle accidents.
The candidate hired will have experience working with insurance companies, patients, and healthcare providers to ensure bills are paid accurately and in a timely manner.
Core Duties and Responsibilities: - Investigate and manage denied claims : Specialists research why auto-related medical claims were denied or underpaid by insurance companies. This requires expertise in medical billing, coding, and common reasons for claim denials.
- Contact insurance companies : A major part of the role involves communicating with auto and health insurance providers to resolve billing issues, rebill unpaid claims, and manage the appeals process.
- Handle accounts receivable : Specialists are responsible for working on aged or unpaid accounts and following up to ensure payment. This may involve identifying bad debt, posting payments, and processing refunds.
- Communicate with patients : In cases where a patient is responsible for a portion of the bill, the specialist may contact them to set up a payment plan or resolve billing discrepancies.
- Resolve complex issues : They investigate and resolve payment issues that involve multiple variables, different payers, and complex billing regulations.
- Ensure compliance : Specialists must adhere to all federal, state, and payer regulations, including HIPAA and the Fair Debt Collection Practices Act (FDCPA).
- Provide detailed reports : They report on accounts receivable status and collection activities to management.
Required Skills and Qualifications: - Medical billing and coding knowledge : Comprehensive knowledge of medical billing and coding procedures is essential. Certifications like Certified Professional Biller (CPB) or Certified Medical Reimbursement Specialist (CMRS) are valuable assets.
- Negotiation skills : Strong negotiation skills are necessary for working with insurance companies and patients to set up payment plans and settle accounts.
- Communication skills : Excellent verbal and written communication is key for discussing sensitive financial and medical information with patients, insurance companies, and healthcare providers.
- Problem-solving abilities : The role requires effective problem-solving to analyze complex claim denials and find solutions for timely payment.
- Attention to detail : Collections specialists must be meticulously detail-oriented to ensure accuracy in billing statements, insurance claims, and patient accounts.
- Technological proficiency : Experience with medical billing software, computer systems, and applications is necessary for researching claims and managing patient records.
- Persistence and resilience : The work can be challenging, requiring a persistent and resilient approach to handle frequent rejections and disputes.
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