The Collections Specialist manages accounts receivable, resolves outstanding patient and insurance balances, and establishes payment arrangements.
- Arrearage Management: Monitor and resolve aged accounts receivable (A/R) for self-pay payers.
- Denial Management: Identify, appeal, and resolve claims specifically related to oncology services, such as chemotherapy administration, radiation therapy, and complex laboratory billing.
- Prior Authorization Verification: Review claims to ensure technical billing compliance.
- Compassionate Collection: Contact patients regarding outstanding self-pay balances using sensitive communication tailored to individuals undergoing cancer treatment.
- Financial Counseling: Identify patients qualifying for financial assistance, foundation grants, or pharmaceutical co-pay assistance programs.
- Payment Agreements: Set up and monitor structured payment plans according to practice guidelines.
- Documentation: Maintain meticulous notes.
- Compliance: Adhere strictly to HIPAA regulations, Fair Debt Collection Practices Act (FDCPA) guidelines, and internal financial policies.
- Experience: Minimum of 2–3 years of medical collections or billing experience, with a strong preference for oncology, hematology, or infusion center backgrounds.
- Bilingual (English/Spanish) ability to speak and translate - preferred.
- Knowledge Base: Deep understanding of ICD-10, CPT, and HCPCS codes unique to oncology.
- Software Skills: Proficiency with medical billing software (e.g., OncoEMR, Aria, Epic, or eClinicalWorks) and clearinghouses.
