Medical Billing and Collections Specialist

  • Garden Grove, CA, USA
  • Full-time

Company Description

Here at CiNQ Recruitment, we believe in finding the right fit, for you and our clients. Whether you seek long-term employment solutions for your business or your next career move, we understand the importance of individual and business needs. With over 30 years of successful staffing and recruiting experience, we excel at providing passive candidates with the right skills and cultural fit for specialized positions. Here is the opportunity to work with an exciting pharmaceutical company.

Job Description

We are seeking a Medical Billing Collections Specialist to join the team! Medical Coding Certification is highly preferred!

Pay Rate: $21-$31/hr 

Key Skills:

  • Highly effective communicator with superior listening, understanding, speaking and writing while influencing patients, care givers, payer representatives and others, answering questions and advancing reimbursement and collection efforts.
  • Proven understanding of processes, systems and techniques to ensure successful billing and collection working with all payer types.
  • Ability to reduce days sales outstanding, recognize additional revenue opportunities, and improve in credit collection rates, while working within the limits of standard or accepted practice.

Job Duties:

  • Review patient files for completeness and accuracy, identify and audit claims, ensure all revenue opportunities are included.
  • Review documents received including Explanations of Benefits (EOBs), Remittance Advices (RAs) and other documents indicating credit balances. Identify reasons for credits, take required corrective action, and take ownership of claims through to timely, successful resolution.
  • Analyze credits, identify trends and recommend process improvement opportunities that will result in credit DSO reduction, superior credit rate and intervals and simplified processes that are responsive to the requirements of specific payers.
  • Review claims with outstanding credit balances and identify actions to successfully resolve. Follow up with insurers and patients to resolve outstanding balances in an environment of excellent customer service focused on building enduring customer and business relationships.
  • Document case activity, communications and correspondence in computer system to ensure completeness and accuracy of account activity and actions taken to resolve outstanding claims issues.
  • Contribute medical claims expertise to the design of training and knowledge transfer programs, materials, policies and procedures to improve the efficiency and effectiveness of the Revenue Cycle Management team.

Education/Experience Requirements:

  • High School Diploma or equivalent required, plus additional specialized training in medical billing preferred.
  • Minimum 3 years’ medical collections experience. Prefer working knowledge of managed care, commercial insurance, and Medicare and Medicaid reimbursement.
  • Medical Coding Certification is highly preferred.

Additional Information

All your information will be kept confidential according to EEO guidelines.