Medical Collections Resume Samples

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FB
F Beier
Francis
Beier
11134 Minerva Ports
Los Angeles
CA
+1 (555) 817 1944
11134 Minerva Ports
Los Angeles
CA
Phone
p +1 (555) 817 1944
Experience Experience
Houston, TX
Medical Collections Manager
Houston, TX
Reichel LLC
Houston, TX
Medical Collections Manager
  • Recommends new approaches, policies, and procedures to influence continuous improvements in department’s efficiency and services performed
  • Assists in evaluation of reports, decisions, and results of department in relation to established goals
  • Maintains individual productivity and performance standards
  • Coaches and assists assigned personnel to maximize productivity and teamwork which includes providing work direction, managing performance, supporting training and development, administering company policies and fostering positive employee relations
  • Develops and institutes collection philosophy for multiple entities along with bad debt companies
  • Presents and effectively conveys MEDNAX Services, Inc. position on delinquent or incorrect payment to insurance companies, patients, MDs and department of insurance
  • Performs assignments accurately and on time, as directed
Detroit, MI
Medical Collections Specialist
Detroit, MI
Orn, Friesen and Feest
Detroit, MI
Medical Collections Specialist
  • Provide counseling and budgeting suggestions in assisting patients with repayment of obligations
  • Analyze and determine reasons for either actual or potential delinquency and assist patients in developing a plan to pay accounts current
  • 7. Provide counseling and budgeting suggestions in assisting patients with repayment of obligations
  • 6. Analyze and determine reasons for either actual or potential delinquency and assist patients in developing a plan to pay accounts current
  • Assist any walk-in patients with their questions, concerns or payments
  • Work directly with, and act as a representative of CPFCC between outside collection agencies or attorneys
  • Make outbound courtesy calls to patients regarding accounts greater than 70-90 days past due
present
Phoenix, AZ
Medical Collections Team Lead
Phoenix, AZ
Krajcik-Koepp
present
Phoenix, AZ
Medical Collections Team Lead
present
  • Assists with Associates’ difficult accounts and workload and continually provide training to the Associates
  • Assist on various special projects as determined by the Manager
  • Assists on various special projects as determined by the Manager
  • Performs other job-related duties within the job scope as requested by Management
  • Works closely with the Manager on a daily basis to ensure a smooth operation within the department
  • Perform other job-related duties, within the job scope as requested by Management of Patient Accounts
  • Assists with tasks, as assigned by the respective department Manager
Education Education
Associate’s Degree
Associate’s Degree
Cornell University
Associate’s Degree
Skills Skills
  • Basic knowledge of FDCPA
  • Basic Knowledge of UB-92 and Explanation of Benefits (EOB) interpretation
  • Basic knowledge of CPT and ICD-codes
  • Ability to work with a team setting and be supportive of the team members
  • Ability to work successfully in a fast paced environment
  • Understanding HIPAA/ regulations
  • Essential computer skills on a PC or Mac
  • Effective verbal and interpersonal skills
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6 Medical Collections resume templates

1

Medical Collections Specialist Resume Examples & Samples

  • 3+ years of Medical Collections experience
  • Certification from an accredited Medical and Billing school
  • Knowledge of Business and Accounting processes
  • Associate's Degree in Accounting, Business Administration, or Health Care Administration
2

Medical Collections Specialist Resume Examples & Samples

  • Certification from an accredited medical and billing school
  • Polished and professional demeanor
  • Knowledge of business and accounting processes usually obtained from an Associate's Degree in Business Administration, Accounting or Health Care Administration
3

Medical Collections Specialist Resume Examples & Samples

  • 4+ years of Insurance Billing and Collections experience
  • Exceptional mathematical skills
  • Orthopedic Surgeon collections experience
4

Medical Collections Associate Resume Examples & Samples

  • Experience working an accounts receivable aging and writing appeals
  • General knowledge of CPT/ICD10
  • Ability to maintain a positive attitude
  • Comfortable working independently and a team environment
5

Temporary Medical Collections Specialist Resume Examples & Samples

  • 50+ collection calls and/or correspondence daily in a fast paced goal oriented medical billing department
  • Timely and accurate tracking of payments, denials and adjustments on the patient’s outstanding accounts receivables via phone and or electronic contact. Accurate and detailed notes will be documented in the patient’s ledger of action taken
  • May require research into insurance carrier’s medical criteria and address patient questions or concerns
  • Report on productivity, collections, procedures, and patient accounts
  • Excellent customer service skills required, 2 years collection and billing experience preferred
  • Ability to read and interpret insurance payer contracts and Explanation of Benefits
  • Strong verbal and written communication proficiency to communicate with external customers to facilitate the collection and billing processes
  • Computer skills including Windows, Microsoft Office, and prior database administration
6

Medical Collections Representative Resume Examples & Samples

  • Collect on past due medical debt via inbound and outbound calls
  • Working with attorney's, insurance and any authorized third party
  • Handle any claim disputes
  • Create payment arrangements with clients
  • Skip tracing
  • Maintain accuracy of assigned work processes
  • Participate in monitoring individual daily work process for compliance with all rules and regulations, accreditation standards and laws that apply, Specially those that fall under HIPAA and FDCPA
  • Initiate reporting of compliance concerns following the Allina Health or business unit specific policy and procedure established for reporting compliance issues
7

Medical Collections Representative Resume Examples & Samples

  • Contacts insurances through a variety of methods (e-mail, form letters and phone calls) to discuss, negotiate payment and resolve outstanding medical bill accounts and balances
  • Obtains agreement, after discussion with customer (Hospitals), on potential balance payoff and/or payment terms within stated level of authority and guideline limits
  • 2+ years of Medical Billing/Collections experience
  • Functional Knowledge of Payer Terminology
  • 6+ months of Claims (Managed Care, Medical Care, Medical Insurance) Resolution experience
  • Certification as a CPAR (Certified Patient Account Representative)
  • Advanced skills interpreting carrier EOBs
  • Previous work experience with UB04 (Form hospitals use to Bill)
  • Previous experience handling Government Medicaid Payers with an of understanding State Guidelines
  • Must possess excellent organizational skills and be able to prioritize workflow
8

Medical Collections Specialist Resume Examples & Samples

  • Growing organization supporting one of the largest healthcare systems in the country
  • Competitive salaries and a monthly bonus opportunity
  • Innovative compensation plan that allow for possible salary increases every 90 days
  • Perform collections activity based on collection queue/production goals
  • Be a mentor to new employees and assist in their training and development
9

Medical Collections Specialist Resume Examples & Samples

  • Contact and follow-up with patients regarding delinquent statement balances and accounts. Must meet minimum performance standards for account contacts per day and maintain an acceptable level of delinquency balances
  • Make outbound courtesy calls to patients regarding accounts greater than 70-90 days past due
  • Document discussions with and/or promises from patients in the collections system
  • Send letters to dismissed patients for balance delinquency and doctor-patient relational problems
  • Locate accounts with old or bad information through skip-tracing
  • Work directly with, and act as a representative of CPFCC between outside collection agencies or attorneys
  • Research and resolve all questions and discrepancies presented by patients
  • Process bankruptcy notifications and suit requests from collection attorney
  • Process correspondence from patients concerns regarding account
  • Process and review statements and refunds
10

Medical Collections Specialist Resume Examples & Samples

  • Experience with medical claims, insurance and collections
  • Be comfortable with both inbound and outbound calling - professional communication skills
  • Have Intermediate Microsoft Office experience (Word, Excel, & Outlook)
  • Ability and knowledge to stay current with changing insurance guidelines
11

Medical Collections Resume Examples & Samples

  • Reviews system-generated accounts receivable reports and payer explanation of payments to identify delinquent client accounts
  • Investigates delinquent accounts/denials to determine accuracy of AR, and determines a collectible balance
  • Contacts payers on collectible accounts for status of accounts
  • Collects outstanding receivables in a timely manner to reduce bad debt and keep AR under 120
  • Aggressively works to collect AR that exceeds 120, in keeping with the Company goal for A/R
  • Documents conversations with payers inclusive of who was contacted, the name of the representative, expected outcome, next steps and date of next follow-up, if any
  • Acts as the patient liaison, calling patients to clarify insurance coverage when it is determined that an update is needed
  • All other duties as assigned by management
  • Previous healthcare reimbursement experience preferred
  • Basic knowledge in the home health care field preferred
  • Good organizational and time management skills
  • Proven success paying careful attention to detail and completing work accurately
  • Effective communications skills for interacting with clients, payers, and co-workers
  • Proficiency in typing, data entry, and telephone etiquette
  • Initiative to plan for and complete daily activities with minimal direction from the supervisor
12

Medical Collections Specialist Resume Examples & Samples

  • Basic Microsoft Office skills, especially Excel and Word (Adecco testing will be required)
  • Previous reimbursement/intake/admissions experience highly preferred
  • Solid work history
13

Days Medical Collections Specialist Resume Examples & Samples

  • Strong attendance pattern is expected
  • Candidates should have the ability to make decisions by using the infrastructure of defined processes
  • Candidates should be able to retain large amounts of information while having the ability to adapt quickly to changes in processes, goals and / or policies
  • Candidates should be open to continuous feedback aimed at enhancing productivity and quality
  • Candidates must thrive in a highly measured and structured environment with individual goals for supporting overall production
14

Medical Collections Manager Resume Examples & Samples

  • Accumulates and postulates theories about collection activities and crafts pilot studies to ascertain the feasibility of those studies
  • Conveys a message of urgency to patients or guarantors about paying balance owed
  • Creates methods of getting delinquent payers to pay using telephone calls, email, correspondence and other technology
  • Sets tone and priority of department related to delinquent accounts
  • Coordinates activities related to collections of delinquent accounts with other departments to ensure activities are efficient and consistent with the rest of the organization
  • Communicates collections of delinquent accounts problems and issues to department head and makes recommendations regarding changes to collections of delinquent accounts approaches, policies and procedures. Advises staff within and outside the department of changes
  • Audits accounts processed by collections department to ensure that accounts are addressed and processed in a timely and correct manner. Provides back-up support as needed
  • Reviews hardship applications received from patients to determine if a discount should be granted
  • Reviews bankruptcy notices and applies them to the correct accounts
  • Prepares monthly productivity and AGE reports for Collections Department
  • Maintains office, department and operational procedures and standards consistently
  • Maintains individual productivity and performance standards
  • Serves as a member of the Collection Department Team. Performs duties necessary to ensure the team’s projects/goals are completed
  • Two-to-four years related experience and/or training required; Bachelor's degree (B.A.) from a four-year college or university; or equivalent combination of education and experience
15

Medical Collections Team Lead-medicare Resume Examples & Samples

  • Assists with Managerial tasks within the respective department
  • Review and audits Associates’ productivity. Identifies Associates’ areas of additional training
  • Assist with Associates’ difficult accounts and workload and continually provides training to the Associates; monitors Associates’ hours worked and provides backup support in Manager’s absence
  • Make necessary telephone or written contact; Contact payers to check claim status and reimbursement; contact parents to obtain accurate insurance information; phone appeals on denied claims; contact payer regarding carrier issues; provide Call Center backup as needed and Send appropriate letters
  • Consistent follow-up on outstanding accounts by running and working collection reports and correspondence
  • Not Worked Report – Summarizes outstanding accounts not worked within the department’s guidelines; 1499 Report – Identifies registered Commercial accounts that have been paid as Managed Care; Denial Report – Identifies specific denials posted from EOB’s received; Residual Report – Identifies balances remaining after payer has made a payment; Queue Summary Report – Identifies the accounts that are scheduled to be worked for a given day; Clearinghouse Reports – Identifies specific denials for claims submitted electronically; Review, distribute and/or work all daily correspondence received from patients and payers
  • Perform audits on accounts when needed
  • Review accounts for accuracy (ie; payments have been posted correctly, appropriate adjustments have been made, etc.)
  • Process and/or review refunds for overpayments made by payers and patients
  • Process and/or review adjustments as necessary (ie; contractual, good faith, settlement, etc.) and appeal denied claims via mail or telephone
  • Request Accounts Receivable Status Reports when a denial trend has been identified; review accounts receivable report detail for denial trends; obtain Medical Records from Hospital Associates and send them to the payer; review diagnosis and procedure codes with the Coding Department and submit and/or monitor problem packs or appeals to payers
  • Update accounts in GPMS with information obtained through correspondence and telephone (ie; insurance, authorization, address, baby’s name, etc.)
  • Review denial reports (GPMS Denial, electronic claims, Not Worked) for payer trends
  • Meet or exceed required departmental productivity standards on a consistent basis
  • Performs a variety of other collection duties
  • Always meets deadline dates and times on assigned projects
  • Work overtime in mandatory situations
  • Maintain strict confidentiality in accordance with HIPAA regulations and Company policy. Any patient private health information (PHI) must not be divulged on any account except to payers that need the information in order to process the claim for payment
  • Presents a positive, professional appearance and conveys a professional demeanor in the performance of assigned duties
  • Performs other job-related duties within the job scope as requested by Management of Patient Accounts
  • Represents the corporation in a positive fashion and makes all individuals feel as comfortable as possible
  • Complies with departmental and company-wide policies and procedures
  • Knowledge of current third party billing and collection regulatory guidelines and requirements
  • Good interpersonal skills and a basic understanding of team management concepts
  • Ability to work independently in a fast paced environment
  • Understanding of medical terminology, protocols anatomy required
16

Medical Collections Admin Resume Examples & Samples

  • Maintains a working knowledge and understanding of CPT and ICD-10 codes. Keeps current with health care practices and laws and regulations related to claims collections through participation in professional development activities
  • Prepares routine management reports, quality reports, and special reports as directed by supervisor. Communicates collection problems to supervisor and makes recommendations for changes
  • Ability to define problems, collect data, establish facts, and draw valid conclusions
17

Medical Collections Specialist Resume Examples & Samples

  • Work on Predictive Dialer and manual to maximize volume of calls
  • Identify and resolve patient billing issues
  • Negotiate on outstanding balances
  • Verify eligibility, payments and claim status with (Medicaid, Medi-cal, Medicare and Commercial Insurances)
  • Perform various collection actions including contacting patients, insurance companies, correcting, resubmitting and appealing claims
  • Perform extensive research on accounts, flight records and internet, also thorough Skip tracing using LexisNexis
  • Knowledge: Working knowledge in Medical billing, codes and medical terminology and HIPAA. Capable of meeting production goals. High school diploma or equivalent
  • Experience: Minimum 3 year experience in collections, medical billing, customer service or equivalent with a proven track record of meeting production goals on a regular basis with experience in providing training and feedback to less experienced collectors. Experience with standard office software products a must
18

Medical Collections Specialist Resume Examples & Samples

  • Responsible for all third party billing and follow-up associated with the dispensing of prescription medication; maintain supporting chronological notes that detail action taken to resolve outstanding account balances. Maintains patient demographic information and data collection systems. Work all billing/collection reports, queues, or diversions according to payer and company policy guidelines
  • Researches and responds by telephone, via the Internet, and in writing to insurance companies and governmental payers regarding billing issues and insurance problems. Follows up on submitted claims; monitors unpaid claims, initiates appeals and resubmits claims as necessary
  • Transmit or submit claims (paper, electronic) to insurance payors for reimbursement
  • Resolve insurance problems and patient issues that may have resulted from incorrect or incomplete information, therapy changes and pharmacy or shipping errors
  • Provide detailed follow up with patients and payors in the form of, but not limited to phone calls, fax transmittals, and emails
  • Contact patients and physician’s offices as needed in order to expedite claims processing
  • Obtain accurate demographic, insurance, and financial information from patients to ensure all account information is accurate
19

Medical Collections Specialist Resume Examples & Samples

  • Supports and adheres to personnel policies and programs which specify privileges and responsibilities of employment, including compliance with an adverse incident reporting system, quality improvement program, patient safety initiatives, and risk management program
  • Displays willingness to speak up about safety issues or change practices to enhance safety; asks for help when needed; enhances teamwork; follows the safety literature/policies
  • Organization– Proactively prioritizes needs and effectively manages resources and time
  • Communication – Communicates clearly, concisely and professionally
  • Customer Orientation – Establishes and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations
  • Decision Making– Identifies and understands issues, problems, and opportunities; compares data from different sources to draw conclusions; uses effective approaches for choosing a course of action or develops appropriate solutions; takes action that is consistent with available facts, constraints, and probable consequences
  • Contributing to Team Success–Actively participates as a member of the Center’s team to move the team toward the completion of goals
  • Minimum 2 year of experience in a medical office setting (i.e. ambulatory surgery center, hospital, doctors office) required
  • Knowledge of insurance verification and appeals
20

Medical Collections Specialist Resume Examples & Samples

  • Work patient accounts
  • Identifies and resolves patient billing issues
  • Evaluates patient’s financial status and establishes payment plans. Follows up on payment of delinquent accounts and updates status
  • Reviews daily credit card transactions and contacts patient for declined transactions
  • Negotiate and offer discounts on outstanding accounts that meet criteria
  • Routinely verifies (Medicaid,Medi-cal,Commercial Insurance,) for eligibility and payments and processing status
  • Enters appropriate information documentation and thorough account notes
  • Maintains Strictest confidentiality; adheres to all HIPPA guidelines/regulations
  • Follows all FDCPA guidelines and regulations
  • Uses outside Skip tracing vendors to find current patient phones #’s addresses and credit scores
  • Performs various collection actions including contacting patients, insurance companies, correcting and resubmitting claims to third party payers
  • Maintains the utmost composure and customer service when interacting with patients, insurance reps, attorneys
  • Previous billing and collections and/or revenue cycle experience preferred
  • Demonstrate ability to work proficiently and efficiently in a timely manner
  • Proficient in Microsoft office, including Excel and Word
21

Medical Collections Resume Examples & Samples

  • Basic knowledge of CPT and ICD-codes
  • Understanding HIPAA/ regulations
  • Basic knowledge of FDCPA
  • Ability to work with a team setting and be supportive of the team members
  • One or more years call center customer service or collection experience
22

Medical Collections Team Lead Resume Examples & Samples

  • Assists with tasks, as assigned by the respective department Manager
  • Reviews / audits Associates’ productivity. Identifies Associates’ areas requiring additional training
  • Assists with Associates’ difficult accounts and workload and continually provide training to the Associates
  • Works closely with the Manager on a daily basis to ensure a smooth operation within the department
  • Makes necessary telephone &/or written contact; Contact payers to check claim status and reimbursement; contact patients / insurance companies to obtain accurate insurance information; phone appeals on denied claims; contact payer regarding carrier issues; send appropriate correspondence
  • Consistently follows-up on outstanding accounts by running and working collection reports and correspondence
  • Performs audits on accounts
  • Reviews accounts for accuracy (i.e.; payments have been posted correctly, appropriate adjustments have been made, etc.)
  • Processes and/or reviews refunds for overpayments made by payers and patients
  • Processes and/or reviews adjustments as necessary (ie; contractual, good faith, settlement, etc.) and appeal denied claims via mail or telephone
  • Requests Accounts Receivable Status Reports when a denial trend has been identified; review accounts receivable report detail for denial trends; obtain Medical Records from Hospital Associates and send them to the payer; review diagnosis and procedure codes with the Coding Department and submit and/or monitor problem packs or appeals to payers
  • Completes appropriate account maintenance by ensuring that the correct statement groups, financial class, and payer codes are current and timely
  • Identifies carrier related denial trends
  • Reviews denial report for payer trends
  • Elevates problems to department Manager
  • Meets or exceeds required departmental productivity standards on a consistent basis
  • Assists on various special projects as determined by the Manager
  • Maintains strict confidentiality in accordance with HIPAA regulations and Company policy. Any patient private health information (PHI) must not be divulged on any account except to payers that need the information in order to process the claim for payment
  • Performs other job-related duties within the job scope as requested by Management
  • Conducts all business in a professional manner maintaining respect for individuals at all times
  • Complies with departmental and company-wide policies and procedures on a consistent basis
  • Maintains constant awareness of potential safety hazards insuring necessary safety precautions
  • Reads and complies with established policies and procedures
  • Consistently adheres to MEDNAX Services, Inc., Department and HR policies and procedures
  • Associate’s degree (A.A.) or equivalent from two-year College or technical school; or one to two years related experience and/or training; or equivalent of education and experience
  • Knowledge of medical insurance terminology, insurance billing guidelines and concepts
  • Understanding of protocols anatomy preferred but not required
23

Medical Collections Team Lead Resume Examples & Samples

  • Update accounts in GPMS with information obtained through correspondence and telephone (i.e. insurance, authorization, address, baby’s name, etc.)
  • Complete appropriate account maintenance by ensuring that the correct statement groups, financial class, and payer codes are current and timely
  • Identify carrier related denial trends
  • Elevate problems to department Manager
  • Average of quality and quantity productivity standards must meet or exceed 95%
  • Perform a variety of other collection duties
  • Assist on various special projects as determined by the Manager
  • Consistently meet deadline dates and times on assigned projects
  • Present a positive, professional appearance and convey a professional demeanor in the performance of assigned duties
  • Perform other job-related duties, within the job scope as requested by Management of Patient Accounts
  • Embody the principles of the corporate Mission Statement and Philosophy at all times
  • Represent the corporation in a positive fashion and make all individuals feel as comfortable as possible
  • Conduct all business in a professional manner, maintaining respect for individuals at all times
  • Maintain constant awareness of potential safety hazards insuring necessary safety precautions
  • Read and comply with established policies and procedures
  • Adhere to MEDNAX Services, Inc., Departmental and HR policies and procedures
24

Medical Collections Specialist Resume Examples & Samples

  • Knowledge of billing and payment policies of various third-party payers as they relate to ambulatory surgeries; knowledge of insurance policy requirements, particularly managed care contract parameters as they related to reimbursement
  • Knowledge of medical terminology, CPT and ICD9 coding relating to ambulatory surgeries
  • Ability to challenge claims rejections, incorrect payments and knowledge of appeal procedures and third party reimbursement
  • Computer skills; knowledge of medical billing software systems
  • Good interpersonal skills, including verbal and written communication skills and pleasant telephone voice and personality
  • Minimum 2 years related experience in collection and medical reimbursement
  • Analytical skills to research and resolve reimbursement discrepancies based on our contracts
25

Medical Collections Specialist Resume Examples & Samples

  • Medical billing overview
  • EOB's, denials and rejected claims
  • Appeals and follow up with Private Carriers, Medicare and Medicaid
  • Comprehension of Insurance plans
  • Documentation of all open and pending claims being worked
  • Collections on unpaid or partially paid insurance claims
  • Medical collections: 3 years
26

Medical Collections Specialist Resume Examples & Samples

  • Follow up associated with the dispensing of prescription medications via telephone, internet and in writing
  • Maintain supporting chronological notes that detail action taken to resolve outstanding balances
  • Maintain accounts receivable systems including all billing/collection reports or queues
  • Contact patients and physicians offices as needed in order to expedite claims processing
27

Medical Collections Specialist Resume Examples & Samples

  • Analyze and determine reasons for either actual or potential delinquency and assist patients in developing a plan to pay accounts current
  • Provide counseling and budgeting suggestions in assisting patients with repayment of obligations
  • Post all patient payments and agency payments to appropriate accounts
  • Prepare accounts to be sent to agency/collection attorney or in-house collections
  • Assist any walk-in patients with their questions, concerns or payments