POSITION SUMMARY:

The Accounts Receivable Patient Collections Specialist is responsible for managing account follow-ups, resolving billing issues, and responding to patient inquiries. This role requires strong customer service skills to assist patients and their families by providing clear explanations of charges and helping to establish appropriate payment arrangements. The specialist also ensures accurate entry of hospital patient charges into the practice management system.

CORE ESSENTIAL RESPONSIBILITIES:

• Review and follow up on patient accounts to resolve discrepancies, denials, and unpaid balances.
• Respond to billing inquiries and initiates collection efforts for past-due accounts, adhering to ethical practices while contacting patients to discuss payment options and negotiate payment plans.
• Maintains patient credit balances by reviewing patient accounts and processing patient refunds in accordance with protocol.
• Performs write-off adjustments for necessary accounts providing appropriate documentation for review by Management.
• Timely entry of hospital charges and demographics in the billing system; reviewing for completeness, accuracy, and compliance with billing guidelines and healthcare regulations.
• Collaborate with providers to resolve charge documentation issues.
• Maintains a complete understanding of HCPCS/ICD-10/CPT oncology coding and specific carrier requirements and participates in meeting and training sessions.
• Verify eligibility and benefits verification for services, as needed and demonstrate a solid working knowledge of insurance processes, including deductibles, out-of-pockets, and copays.
• Maintain accurate notes in EPIC and ensure compliance with documentation standards.
• Support other revenue cycle functions as needed and perform additional duties as assigned.

EDUCATION & EXPERIENCE:

• High school diploma or equivalent required; associate degree in health sciences preferred.
• Minimum 3–5 years of experience in medical accounts receivable, with oncology/hematology billing preferred.
• At least 5 years’ experience in private practice accounts receivable and charge entry.

KNOWLEDGE, SKILLS OR ABILITIES

• Excellent customer service, communications skills and the ability to deal with patients regarding sensitive financial matters.
• Working knowledge of HCPCS, ICD-10, CPT coding, and compliance with HIPAA and healthcare billing regulations.
• Proficient using electronic health record and Practice Management systems (e.g., EPIC).