Medical Collections Specialist
At SCP Health, what you do matters
As part of the SCP Health team, you have an opportunity to make a difference. At our core, we work to bring hospitals and healers together in the pursuit of clinical effectiveness. With a portfolio of over 8 million patients, 7500 providers, 30 states, and 400 healthcare facilities, SCP Health is a leader in clinical practice management spanning the entire continuum of care, including emergency medicine, hospital medicine, wellness, telemedicine, intensive care, and ambulatory care.
Why you will love working here:
- The amazing Revenue Cycle Services culture – we value people, process and technology
- Flexible schedule
- Strong track record of providing excellent work/life balance
- Comprehensive benefits package and competitive compensation
- Commitment to fostering an inclusive culture of belonging and empowerment through our core values - collaboration, courage, agility, and respect.
What you’ll be doing:
Medical Collection Specialists support the general activities and claims adjudication of the Medical Collection department with denial management and appeals for designated rejections. They will be the subject matter expert on their specific segment of the business unit.
- Review Accounts Receivable (AR) by payer daily to ensure reimbursement goals and days in AR are maintained or achieved
- Research and resolve invoices routed to the Specialists Views; to include Escalated Views, CE View, Correspondence View, Rejection View, etc.
- Prepare required appeals relating to past timely filing, medical necessity, and other denials
- Prepare reports for management denial and rejection trending reports and facility analysis
- Provide regular feedback to management, based on research and calls to payers, to establish payer behavior trends
- Provide weekly feedback on payer/facility adjudication concerns
- Document and ensure each SCP Health Special Arrangement is processed correctly and returning the expected results
- Produce a minimum of 55 outcomes per day on Medical Collection Views
- Achieve a minimum score of 90% on Quality Assurance audits
Who/What we are looking for:
- You understand the overall revenue cycle process through final adjudication of accounts
- You are detail oriented, organized and enjoy working in a team environment that is metric focused
- You have at least 3 years of direct Medical Insurance Denials Management experience, Central Billing Office experience preferred
- You have experience working Provider Emergency Medicine and/or Provider Hospital Medicine claims preferred, Provider Worker’s Compensation claims experience is also a plus!
- You have experience adjudicating medical claims from Government and/or Commercial payers.
- You are tech savvy with Medical Billing Systems experience, experience with AthenaIDX and/or OnBase a plus and have EMR experience.
- You have Microsoft Office experience with at least intermediate Excel and Outlook skills and beginner Word skills
- You have a high school diploma or GED required
SCP Health and its affiliated companies (collectively, “SCP Health”) require applicants for specific positions, such as those onsite at a client company/healthcare facility or affiliate to be vaccinated against COVID-19 as a condition of employment, except where prohibited by state or local law. To demonstrate compliance with SCP Health’s vaccination policy, proof of COVID-19 vaccination status will be requested upon a conditional offer of employment for onsite positions at a client company/healthcare facility. SCP health will consider religious and/or medical/disability accommodation and other legally required exemption request as required by applicable law.
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SCP Health is an Equal Opportunity Employee.