Accounts Receivable Specialist/Collections

$41,600 - $52,000/Yr

BrightStar Care - Plano, TX

Full-time - Entry Level

Plano, TX

Ambulatory Health Care Services

About the position

Bright Star Care of Plano is seeking an experienced Medical Collections/Accounts Receivable Representative to join our Accounts Receivable Department. This full-time position is based in Plano, TX, and requires candidates to have a minimum of 3 years' experience in healthcare payment recovery, specifically from commercial, government, and Workers Compensation payers, including patient collections. The role involves contacting medical insurance carriers to resolve claims and responding to claim denials or underpayments through our appeals process. The ideal candidate will be responsible for identifying delinquent accounts, reviewing each account via reports, and maintaining an average productivity of 45 accounts per day. This includes reviewing insurance balances, performing collection actions such as appeals and resubmitting claims, and maintaining strict confidentiality. Excellent customer service skills are essential, as the representative will need to communicate tactfully with team members and insurance companies regarding accounts, both verbally and in writing. Additionally, the representative will resolve all incoming insurance correspondence related to denials and incorrectly processed claims, while also performing other duties as assigned by their direct report. Candidates should possess strong organizational skills, attention to detail, and proficiency in a Windows environment, along with a solid understanding of medical claims processes and regulations.

Responsibilities

• Contact medical insurance carriers for claim resolution.
• Respond to claim denials or underpayments through the appeals process.
• Identify delinquent accounts and aging periods.
• Review each account via reports with an average productivity of 45 accounts per day.
• Review insurance balances and perform collection actions including appeals and resubmitting claims.
• Maintain strict confidentiality of patient information.
• Provide excellent customer service in all communications.
• Resolve incoming insurance correspondence pertaining to denials and incorrectly processed claims.
• Perform other duties as assigned by the direct report.

Requirements

• High school diploma or equivalent.
• Minimum of 3 years' experience in accounts receivable within a healthcare setting.
• Proficient in medical claims processes including EOB review and analysis.
• Knowledge of appeals processes and payment processing rules.
• Ability to understand managed care contracts and state laws pertaining to payment of claims.
• Good business writing skills and organizational skills.
• Detail-oriented with the ability to manage multiple accounts.

Nice-to-haves

• Experience with ICD-10 coding (1 year preferred).
• Experience in home health (1 year preferred).
• Experience in medical collections (2 years preferred).

Benefits

• Dental insurance
• Health insurance
• Paid sick time
• Paid time off
• Vision insurance