Collections Specialist

Collections Specialist

• Follows government and third-party payor guidelines to ensure complete and timely follow-up on claims that have open balances, were rejected, or denied.
• Performs appeals by following government and third-party payor appeals guidelines. Review payor contracts and fee schedules to perform underpayment appeal Contacts patients or appropriate payor representatives via phone or electronically to coordinate benefits and submits claim in the correct filing order. Works to identify other payors when possible and ensures all payors and filing order is current in the registration application.
• Collaborates with the Revenue Cycle Analyst to identify patterns and interpret denial trends. Notifies Manager when insurance plans deny services, which are covered based on the contract terms or government guidelines.
• Works to minimize write-offs by exhausting all resolution options and performing thorough research/review of all appropriate resources. Adjusts account or requests write-offs adhering to Connect Hearing policies and procedures.
• Reviews denial reports and makes recommendations for edit modifications and additions based on claim denials. Analyzes and tracks appeals.
• Meets productivity and quality standards
• Research payor and government websites and medical resources, to identify payor claim requirements required to resolve open accounts receivable.
• Collaborates with Coding Analyst/Specialist or Clinician to resolve coding-related denials.
• Targets and reports any internal procedures or processes that may increase days in accounts receivable or delay claim resolution.
• Interacts with patients, government, and third-party payors to respond to billing requests.
• Provides customer service for patients by responding to inquiries and processing and posting patient credit card payments as needed.
• Documents using standardized notes for all insurance follow-up and account resolution activities in the revenue cycle application.
• Remains current with trends, regulatory requirements, and business strategies related to the revenue cycle.
• Operates in compliance with all local, state, and Federal laws as well as Company policy and compliance standards
• Other duties and responsibilities as assigned

• Knowledge of government and third-party payor claims submission, denial resolution, and appeals processes
• Knowledge of Durable Medical Equipment requirements
• Experienced with patient accounting systems
• Experienced with paper and electronic CMS-1500 claim requirements
• Medical terminology required for accurate claims processing
• Knowledge of CPT, HCPCS, and ICD coding systems

• Ability to interpret and apply government and third-party payor billing guidelines, claim rules, and contract terms
• Detail-oriented with a high level of problem-solving skills
• Ability to work effectively within designated time frames
• Ability to collaborate and work cohesively as part of a team
• Experience working in revenue cycle applications to resolve patient accounts
• Communicates effectively orally and in writing
• Experience with Word and Excel

• 3- 4 years of related experience in a physician or hospital setting
• Previous experience in a centralized business office is preferred

• Medical, dental, and vision coverage*
• Health Savings, Health Reimbursement, Flexible Spending/Dependent Care Accounts
• TeleHealth options
• 401k plan with company match*
• Company-paid life/AD&D insurance
  • Additional supplemental life/AD&D coverage
• Company-paid Short/Long-Term Disability coverage (STD/LTD)
  • STD LTD Buy-ups are available
• Accident/Hospital Indemnity coverage
• Legal/ID Theft Assistance
• PTO, floating Diversity Day, & paid holidays*
• Paid parental bonding leave
• Employee Assistance Program (24/7 mental health support hotline, 5 company-paid counseling sessions, and more)
• Robust Internal Career Growth opportunities
• Tuition reimbursement
• Hearing aid discount for employees and family
• Internal social recognition platform
• D&I focused: D&I council and employee resource groups
• Plan rules/offerings dependent upon group Company/location.


Sonova is an equal opportunity employer.
We team up. We grow talent. We collaborate with people of diverse backgrounds to win with the best team in the marketplace. We guarantee every person equal treatment regarding employment and opportunity for employment, regardless of a candidate’s ethnic or national origin, religion, sexual orientation or marital status, gender, genetic identity, age, disability, or any other legally protected status.