Description
Community Options, Inc. is a national non-profit agency providing services to individuals with disabilities in 12 states.
We are actively seeking a
Healthcare Collections Specialist in
Newtown, PA to support our finance team and ensure the financial health of our Medicaid programs. The Collections Specialist will play a vital role in ensuring timely payments, maintaining accurate financial records, and collaborating with the local offices and Medicaid entities to resolve outstanding balances. This role will report to the Collections Manager and will work hand in hand with the manager to ensure the financial health of all Medicaid programs for the organization.
This is an onsite opportunity.
Starting Salary: $60,000 per year
Responsibilities
- Ensure that the organization receives all necessary payments at the correct, and contracted rate from each consumer insurance company
- Review insurance carriers’ denial reports, remittances, and correspondence to find issues preventing payment
- Analyze accounts receivables and collections data, in search of trends and patterns to improve billing, collections, and DSO results
- Resolve consumer insurance balances by analyzing denials and using critical thinking skills and knowledge of payor requirements to determine the steps needed to obtain payment
- Based on payer processes, utilize payer portals, paper/electronic remits and/or place calls to the payer to understand and resolve denials
- Review data on insurance authorizations to ensure accurate claim processing and payment
- Work accounts holistically, building on the last intervention and not repeating tasks
- Complete projects assigned for specific payers or specific types of accounts, ensuring deadlines are met
- Strive to achieve and maintain company Days Sales Outstanding and Account Receivable aging standards
- Create a tickler file to ensure timely follow-up of outstanding claims/balances consistent with the timely filing limits of the payors
- Develop and submit appeals, including supporting documentation as needed
- Prepare a weekly report with status updates and communication taken on problem accounts
- Ability to manage daily job functions along with special project work and prioritize the level of importance on demand
- Uphold the strictest confidentiality and adhere to all HIPAA guidelines/regulations
- Keep accurate and thorough records of all communications and follow-up relating to the accounts that the position is responsible for
- Perform other duties as assigned by management.
Minimum Requirements
- At least two years’ experience, preferably with a background in admissions, social services, administration, and/or public relations
- High school diploma or equivalent, Bachelor’s or associate degree preferred
- Familiarity with Social Security and Medicaid
- Knowledge and understanding of local and regional regulatory operations
- Knowledge and understanding of state regulations
- Experience with intake and admissions
- Working Knowledge of ICD-10 codes
- Therap experience is a plus
- Proficiency in Microsoft Outlook, Word, and Excel
- Employment is contingent upon successful completion of checks of criminal background, central registry, child abuse registry, and drug testing
Why Community Options? - Competitive Insurance Benefits (Medical, Dental, Vision)
- Paid Holidays—Including a Birthday Holiday
- Generous PTO
- Employee Incentive & Discount Programs
- 403b Retirement Plan
- Incredible career growth opportunities
- University partnerships that include tuition reduction
Please Visit Our Website to Complete an Online Application! Careers.comop.org
Community Options is an Equal Opportunity Employer M/F/D/V #IND-NA
