Collections Specialist Full Time

USPI Center for Advanced Surgery is hiring a Collections Specialist Full Time!

Welcome to USPI Center for Advanced Surgery. USPI Center for Advanced Surgery is a fast-paced ASC environment committed to producing the highest quality work and experience for patients and their families. 

Job Summary:

Under the direction of the Business Office Manager, the Collections Specialist is responsible for:

• Follow up on delinquent surgery center claims (working an expected number of claims per day) - majority of claims will have been submitted to various insurance carriers electronically.
• Knowledge of how to interpret a managed care contract, Medicare and Medicaid and Workers Compensation claims is a must. Tools will be given to calculate allowable and required to determine appropriateness of reimbursement and appeal claims as necessary.
• Extensive contact with insurance carriers of all types, as well as communication with patients regarding out of pocket amounts is required.
• Identification of accounts that have been either under or over paid, issuing credit balance information either to the insurance carrier or the patient.
• All of these practices done in a professional and communicative manner, per policies and procedures, guidelines, internal control measures and established goals.
• The Collection Specialist must be a team player and have ability to communicate well with direct reports, patients, customers, insurance carriers, etc.
• Ability to manage accounts worked independently, and in a productive manner.
• Must project a professional demeanor and appearance while maintaining the confidentiality of the surgery center and patients.
• Works well in stressful environment and in situations that demand patience.
  Projects a professional demeanor and appearance while maintaining the confidentiality of administration, patients, physicians and employees.
• Works under stress and in situations that demand patience and tact while providing impeccable service.

What We Offer

As a valued member of USPI, your health and well‑being are important to us. We are proud to provide you and your dependents with valuable and significant benefits. USPI knows the value of well-rounded, balanced employees, which is why we offer a variety of additional benefits to help manage life’s daily stresses. USPI offers the following benefits, subject to employment status:

• Medical, dental, vision, disability, and life insurance
• Paid time off (vacation & sick leave)
• 401k retirement plan
• Paid holidays
• Health savings accounts, healthcare & dependent flexible spending accounts
• Employee Assistance Program, Employee discount program
• Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long-term care, elder & childcare, AD&D, auto & home insurance

Who We Are

At USPI, we create relationships that create better care. We partner with physicians and health care systems to provide first class ambulatory solutions throughout the United States. We are committed to providing surgical services in the most efficient and clinically excellent manner. USPI is committed to, and proud of our inclusive culture. An inclusive culture, in our view, is respectful of differences and nurtures and supports the contributions of each individual, while also embracing and leveraging diversity. A diverse workforce, combined with an inclusive culture, makes USPI stronger and better able to meet the needs of our diverse patient and physician population.

For more information about USPI, check out our website, Facebook, Twitter, or LinkedIn.

Qualifications

• High School Diploma or equivalency.
• 1-2 years of previous medical claims experience
• Experience in government payer claim adjudication (Medicare, Medicaid, VA, Tricare) and commercial payers (BCBS, Aetna, Cigna, UHC, etc.)
• Familiar with reading contracts and have the ability to apply those rules to an EOB and determine a follow up/resolution path.
• Familiar with grievance and appeals process.
• Ability to read an EOB
• Strong interpersonal communication skills, verbal and in writing.
• Must have experience with Windows applications and able to manage Excel spreadsheets (edit, sort, filter, etc.)
• Medical terminology.
• Comfortable utilizing critical thinking skills.
• Prefer previous experience working with Advantx (Patient Accounting System).
• Prefer previous experience with Electronic Health Record system, but will train.