Revenue Cycle Collections Specialist

As a Revenue Cycle Collections Specialist at USA Clinics Group, your main responsibilities will include managing patient delinquent accounts, establishing repayment agreements, and handling communications with insurance carriers regarding claim statuses, denials, and underpayments. You will also engage in tasks such as researching outstanding claim issues, submitting appeals for denied claims, and ensuring that proper documentation is provided to insurance. Your role is vital in ensuring the efficiency of our revenue cycle operations.

To qualify for the Revenue Cycle Collections Specialist role at USA Clinics Group, candidates must have at least two years of experience in medical collections. A solid understanding of insurance remittance, denial codes, and the ability to navigate provider portals is essential. Moreover, experience with multi-state insurance denials and familiarity with major insurers like Aetna, BCBS, and UHC are preferred. Exceptional customer service skills and a strong personality to effectively communicate with insurance representatives are also crucial.

The Revenue Cycle Collections Specialist at USA Clinics Group can expect a comprehensive benefits package that includes health insurance with dental and vision coverage, retirement planning with a 401k and matching, and paid time off that includes sick time. Additionally, this role presents ample opportunities for career advancement, allowing employees to grow and develop within the company as they enhance their skillsets and contributions.

The work environment for the Revenue Cycle Collections Specialist at USA Clinics Group is fast-paced and collaborative. Working closely with the Revenue Cycle team, you will often interact with colleagues and insurance representatives to resolve claims efficiently. The company promotes a supportive culture where teamwork and communication are essential, making it a great place for motivated individuals to thrive.

Unfortunately, remote work is not an option for the Revenue Cycle Collections Specialist position at USA Clinics Group. This role requires candidates to commute to the Northbrook, IL office from Monday to Friday, as on-site collaboration is crucial for managing claims and engaging with the team effectively.

When discussing your experience with medical collections, highlight specific roles you’ve held and the responsibilities you managed. Mention any particular challenges you faced and how you overcome them, focusing on your skills in negotiating repayment agreements and resolving denied claims.

Addressing denied claims involves a few key steps: thoroughly reviewing the denial reasons, researching the particular case, and then reaching out to the relevant insurance provider. Highlight your systematic approach to identifying and rectifying the issues, as well as your communication strategy when interacting with insurance representatives.

Discuss any specific software tools or platforms you are familiar with, such as Availity or Navinet, and how they’ve aided in your collection efforts. Be sure to mention any experience you have with Excel, especially in tracking claims or creating reports.

Effective prioritization is essential in a high-volume environment. Explain your method for categorizing and addressing claims based on urgency, potential revenue, or required follow-ups, while ensuring no claim is overlooked.

Detail the strategies you employ to effectively resolve disputes, which could include gathering supporting documentation, clearly communicating the basis for your appeal, and maintaining a professional demeanor even in challenging situations.

If you have experience with multi-state insurance claims, share some examples where different regulations or requirements came into play. Focus on how you navigated these complexities and ensured compliance while optimizing the collection process.

To answer this question, demonstrate that you’ve researched USA Clinics Group. Discuss their mission and how efficient revenue cycle management is key to their success. Tie this in with your potential contributions as a Revenue Cycle Collections Specialist.

Emphasize your understanding of HIPAA regulations and other compliance standards relevant to medical collections. Discuss how you ensure that patient information is kept confidential while handling claims effectively.

Express your motivation for achieving collection targets and resolving patient/account challenges. Discuss the satisfaction you derive from helping patients while also contributing to the organization’s bottom line, linking it back to your commitment to customer service.

Outline your career aspirations and how they align with the opportunities available within USA Clinics Group. Highlight your desire for growth, learning opportunities, and your aim to contribute meaningfully to the revenue cycle team.