Collections Specialist

Written by spartanburg - - Comments Off on Collections Specialist
Spartanburg Regional Medical Center
April 23, 2021
Spartanburg, South Carolina
Job Type


Collections Specialist

  • Spartanburg, SC
  • Home Office: 700 N Pine Street, Spartanburg, SC 29302
  • Business Services
  • Full-Time - Days - 8AM-4:30PM
  • Administrative/Clerical
  • Job Grade 011
  • Req #: 39290


Position Summary


The Collections Specialist is responsible for managing and collecting on accounts receivables for all insurance carrier plan services billed through the hospital/physician billing systems.


Minimum Requirements



  • Highs School Diploma or equivalent



  • Minimum of 1-year medical office or medical billing/collections experience in a hospital or centralized billing setting.
  • Must possess knowledge of CPT, HCPCS, and ICD-9/10 codes.
  • Must have a good working knowledge with insurance explanation of benefits (EOB) and comprehensive understanding of remittance and remark codes.
  • Be familiar with multiple payer requirements for claims processing
  • Solid skills with Microsoft office with a focus on Excel and Word.
  • Good Communication Skills



  • N/A


Preferred Requirements


Preferred Education

  • N/A


Preferred Experience

  • 4+ years’ experience in a centralized billing setting.
  • Payer Focused collections experience
  • Possess an in-depth working knowledge and experience with all types of insurance billing guidelines: Commercial, Medicare Part A and B, Medicaid, Managed Care plans etc.
  • Experience with multiple specialty billing, collections and denials


Preferred License/Registration/Certifications     

  • N/A


Core Job Responsibilities


  • Collections of all outstanding claims by direct payer contact, utilization of payer websites, and through EDI/Claims systems.
  • Research and Resolve all payments issues/errors for insurance balances.
  • Responsible to complete all error corrections and insurance updates to the facility/professional claim in order to resolve outstanding denial/issue preventing payment.
  • Complete claim corrections, coding research requests, as needed to manage outstanding AR.
  • Responsible for handling all retro-authorizations for multiple payers.
  • Must possess the ability to work in different systems including claims eligibility, online payer claims system, case management as well as all AR management systems.
  • Work payer denials and perform all necessary rework for reimbursement of denied services.
  • Work closely with multiple departments to obtain necessary information to resolve outstanding AR.
  • Update and verify insurance records as needed to correct outstanding accounts.
  • Must have working knowledge of registration, payment posting, error correction and other billing functions.
  • Manage time and job responsibilities in order to meet monthly goals
  • Exhibit professionalism and good customer service skills.
  • Other duties as assigned.




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