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A Healthcare Collections job involves managing and overseeing the process of collecting payments for medical services provided to patients. Professionals in this role work within healthcare organizations, such as hospitals, clinics, or medical billing companies, to ensure that outstanding balances are collected in a timely and efficient manner. Here is a typical Healthcare Collections job description:

Job Title: Healthcare Collections Specialist

Job Summary: The Healthcare Collections Specialist is responsible for managing the collection of outstanding patient accounts, ensuring timely and accurate reimbursement for medical services provided. This role involves interacting with patients, insurance companies, and other stakeholders to resolve billing issues and secure payments.

Key Responsibilities:

1. Patient Account Management:
   • Review and analyze patient accounts to identify outstanding balances.
   • Contact patients to discuss billing matters, provide explanations, and answer inquiries.
   • Set up payment plans or negotiate settlements with patients based on established policies.
2. Insurance Claims Resolution:
   • Work with insurance companies to resolve claim denials and ensure accurate reimbursement.
   • Verify insurance information and follow up on pending claims to expedite the reimbursement process.
3. Payment Processing:
   • Process payments received from patients and insurance companies.
   • Record and reconcile payments with outstanding balances in the billing system.
4. Documentation and Reporting:
   • Maintain accurate and up-to-date records of all collection activities.
   • Generate reports on collection performance, outstanding accounts, and other relevant metrics.
5. Compliance:
   • Stay informed about healthcare billing regulations and compliance requirements.
   • Ensure that all collection activities adhere to relevant laws and ethical standards.
6. Customer Service:
   • Provide excellent customer service to patients, addressing their concerns and inquiries professionally and empathetically.

Qualifications:

• High school diploma or equivalent; some positions may require a degree in healthcare administration or a related field.
• Proven experience in healthcare collections or medical billing.
• Knowledge of medical coding, insurance processes, and billing procedures.
• Strong communication and negotiation skills.
• Familiarity with healthcare billing software and systems.
• Attention to detail and ability to work in a fast-paced environment.

Preferred Skills:

• Certification in Medical Billing and Coding.
• Familiarity with relevant healthcare laws and regulations.
• Experience with Electronic Health Records (EHR) systems.

Note: The specific requirements and responsibilities may vary depending on the organization and the level of the position within the healthcare collections department.