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Senior Collections Specialist

3 months ago

Irvine, North Ayrshire, United Kingdom TRC Total Renal Care Inc Full time

Location: Remote

Position Overview:

Are you looking for a workplace that values teamwork and enjoyment? Do you aspire to make a significant impact while advancing your career in the healthcare sector? If so, consider becoming a part of our vibrant team, where we emphasize both personal and professional development, and where your contributions have a direct effect on the lives of our patients.

TRC Total Renal Care Inc is expanding its Senior Collections Team with a focus on Special Projects. This role is essential in optimizing reimbursements from various insurance providers by addressing intricate denials, underpayments, billing discrepancies, and other claim-related challenges.

Key Responsibilities:

  • Oversee assigned lists of outstanding claim balances and patient accounts, tackling complex issues across multiple payers and patient demographics.
  • Identify patterns, perform follow-ups, and conduct root cause analyses on unpaid and underpaid insurance claims from various sources.
  • Implement necessary actions to resolve outstanding balances in line with established protocols, including thorough research, appeals, rebilling, securing insurance authorizations or referrals, correcting coding inaccuracies, and engaging in direct communication with payers or clinics.
  • Address issues related to coordination of benefits (COB), demographic inconsistencies, insurance eligibility, authorizations, and referrals as required.
  • Manage patient benefit-related denials, verifying plan requirements, assessing financial risks, and addressing other factors influencing reimbursement.
  • Navigate through various payer systems, provider portals, and internal applications to ensure timely and accurate resolution of claims.
  • Maintain regular communication with payers, employers, and patients to facilitate resolution.
  • Develop strategic business relationships with internal and external partners, including the Billing & Coding Team, Registration Department, Credit Department, clinical colleagues, and payers.
  • Utilize exceptional organizational, written, and verbal communication skills to keep detailed documentation of research findings and actions taken on claims.
  • Adhere to strict confidentiality standards for all company and patient information in compliance with HIPAA regulations and company policies.

Schedule:

  • Standard 8-hour shift with potential for overtime; operating within regular business hours, Monday through Friday.

Qualifications:

  • Required: High school diploma or equivalent; Preferred: Associate or Bachelor's degree.
  • Required: Proficient in Microsoft Office suite, including Excel, PowerPoint, Word, and Outlook.
  • Required: Minimum of 2 years of experience in healthcare revenue cycle, with a focus on collections.

What We Offer:

Beyond competitive pay, our rewards package connects team members to what matters most. Team members are eligible to begin receiving benefits on the first day of the month following or coinciding with one month of continuous employment. Below are some of our benefit offerings:

  • Comprehensive benefits: Medical, dental, vision, 401(k) match, paid time off, PTO cash out.
  • Support for you and your family: Family resources, counseling sessions, access to wellness apps, backup child and elder care, maternity/paternity leave, and more.
  • Professional development programs: We offer a variety of programs to help strong performers grow within their careers and provide on-demand virtual leadership and development courses through our online training platform.

At TRC Total Renal Care Inc, we strive to be a community first and a company second. We want all team members to experience our organization as a place where they belong. Our goal is to embed Diversity & Belonging into everything we do, making it an integral part of our identity. We are proud to be an equal opportunity workplace and an affirmative action employer.