Collections Specialist
- OUR CULTURE OF PERSON-CENTERED CARE
- At Memorial Hospital of Sweetwater County, our mission, vision, and values serve as the foundation for how we care for patients, support our practitioners and co-workers, and engage with our community. We follow the "Planetree" methodology of "Person-Centered Care". These guide our decisions, shape our culture, and define the expectations for every member of our team.
Our Mission: Compassionate care for every life we touch
Our Vision: To be our community's trusted healthcare leader
Our Values:
• Be Kind - Demonstrating compassion, consideration, and thoughtfulness
• Be Respectful - Being mindful of individual perspectives, priorities and needs
• Be Accountable - Taking responsibility for our commitments, behaviors, and actions
• Work Collaboratively - Cooperating with and encouraging each other to achieve a common goal
• Embrace Excellence - Dedicated to setting standards that meet and exceed expectations
- At Memorial Hospital of Sweetwater County, our mission, vision, and values serve as the foundation for how we care for patients, support our practitioners and co-workers, and engage with our community. We follow the "Planetree" methodology of "Person-Centered Care". These guide our decisions, shape our culture, and define the expectations for every member of our team.
- JOB SUMMARY
- The Patient Financial Services (PFS) Collections Specialist is responsible for resolving outstanding patient and insurance account balances in a timely, accurate, and professional manner to support the hospital's revenue cycle and financial integrity. This position focuses on follow-up and collection activities for hospital and clinic accounts, including insurance balances, patient responsibility, and self-pay accounts.
- JOB QUALIFICATIONS
- Education:
- High school Diploma or it's equivalent required
- Certifications/Licenses:
- Collections, billing, or revenue cycle certification (e.g., CRCS, CPB, or equivalent), preferred.
- Job Knowledge and Skills:
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- Working knowledge of hospital and clinic billing processes, including insurance, patient responsibility, and self-pay accounts.
- Understanding of revenue cycle workflows, including billing, follow-up, collections, denials management, and account resolution.
- Knowledge of payer requirements, reimbursement methodologies, and claim follow-up processes for commercial insurance, Medicare, Medicaid, and other governmental or entitlement programs.
- Ability to identify and resolve non-payment issues, including denials, underpayments, and billing errors.
- Experience processing payments, adjustments, refunds, and financial class updates in accordance with hospital policies and payer guidelines.
- Proficiency in electronic billing and account management systems, including working assigned accounts and documenting activity accurately.
- Ability to communicate professionally and clearly with patients, insurance carriers, and internal departments regarding account status and balances.
- Strong customer service skills, with the ability to handle sensitive financial information and difficult conversations with professionalism and empathy.
- Solid understanding of HIPAA, patient confidentiality, and healthcare regulatory requirements.
- Strong attention to detail and accuracy when reviewing account information and documentation.
- Effective organizational and time-management skills, with the ability to prioritize workload and meet deadlines in a high-volume environment.
- Ability to work independently and collaboratively as part of a revenue cycle team.
- Basic proficiency with Microsoft Office applications and healthcare information systems.
Preferred Skills - Collections
- Prior experience in insurance and/or self-pay collections within a healthcare or hospital revenue cycle environment.
- Advanced ability to negotiate payment arrangements and communicate effectively with patients regarding balances, payment options, and financial responsibility.
- Experience working aging accounts, including accounts over 90/120 days, and taking appropriate escalation actions.
- Familiarity with denials follow-up, appeal processes, and payer correspondence related to unpaid or underpaid claims.
- Experience using account tracking tools and workqueues to manage collections activity efficiently (e.g., ATB, Heat Tracker, or similar tools).
- Ability to de-escalate difficult conversations while maintaining professionalism, empathy, and compliance.
- Knowledge of financial assistance programs, payment plans, and charity care policies, preferred.
- Strong commitment to customer service and person-centered care while balancing organizational financial goals.
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- Education:
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