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Claims and Collections Specialist – Somerville, MA

DEPARTMENT

Billing

LOCATION

Somerville, Mass.

EDUCATION

High School or GED

EXPERIENCE

3-5 years

JOB DESCRIPTION

The Claims and Collection Specialist is responsible for collections of outstanding private invoices from the existing client base, resolving customer billing problems and reducing accounts receivable delinquency. This position will report to the Credit & Collections Manager.

RESPONSIBILITIES

General

  • Make outgoing and receive incoming calls for A/R follow-up regarding denied or rejected claims for assigned payers;
  • Submit written and electronic appeals to insurance carriers and obtain timely status updates;
  • Resolve insurance related billing issues with patients and/or insurance carriers;
  • Handling of high call volume;
  • Serve as primary representative for patient inquiries/calls;
  • Communicate effectively both orally and in writing;
  • Respond to customer inquiries, resolve client discrepancies, process and review account adjustments;
  • Demonstrate superior customer service skills and problem solving, which includes assisting the patient with alternative payment options and payment plans;
  • Poses basic understanding of government and commercial insurance and Credit & Collections policies;
  • Using variety of tools verify and add insurances info to patients’ accounts;
  • Identify the need and request rebills;
  • Handle highly confidential information with complete discretion;
  • Maintain confidentiality of patient information while on the phone or in-person;
  • Work aged invoices utilizing various reports and the collection module using Zoll Rescue Net;
  • Alert Credit & Collection Manager about potential problems that could affect collections;
  • Meet productivity goals/benchmarks as set and communicated by the manager;
  • Utilize available sources to obtain updated info and reissue correspondence;
  • Additional projects and responsibilities may be assigned as needed such as general office duties such as filing, faxing, scanning, and etc.

 

QUALIFICATIONS

  • 3-5 years Accounts Receivable follow up regarding denied or rejecting claims;
  • Knowledge of written and electronic appeals;
  • Working knowledge of Microsoft Office, including Excel, Word is a must;
  • Strong communication, problem solving and analytical skills required;
  • Acute attention to detail and the ability to work in a fast-paced, team-oriented environment with a focus on communication required;
  • Outstanding customer service and phone skills;
  • Previous collections or customer service experience a plus;
  • Knowledge of HIPPA and healthcare policies a plus;
  • High School diploma or GED required;
  • Fluent in Spanish a plus, but not required;
  • Must be positive and maintain professional demeanor at all times;
  • Familiarity with Medicaid and Medicare guidelines;
  • Ambulance billing experience a plus.

 

The above are intended to describe the general nature and level of the work being performed by the person/people in this position. This is not an exhaustive list of all duties, responsibilities, knowledge, skills, and abilities associated with this position. Cataldo Ambulance is an Equal Opportunity / Affirmative Action Employer All qualified applicants will receive consideration for employment without regard to disability, race, color, veteran status, religion, sex, or national origin. Individuals with Disabilities and Veterans are encouraged to apply.

 

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