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Collections Specialist

St. Paul, Minnesota 55126

Job ID: 8550 Category: Professional

Job Description

  • Collect on all outstanding balances for assigned payers
  • Submit appeals as necessary for assigned payers
  • Research and reconcile credit balances on accounts
  • Process corrected claims and/or rebills to assigned payers as needed
  • Process adjustments following the established policy and procedures
  • Process refunds timely according to the work instruction for Refund and Recoupment and Substantial Overpayment Identification
  • Document and follow up on explanations of benefits (EOBs)
  • Enter and work all denials received in a timely manner
  • Identify problem payers and notify Manager and Payer Relations in timely manner
  • Return calls to payers within 1 business day
  • Assist with customer calls
  • Verify benefits as necessary
  • Generate and work clearinghouse report
  • Maintain understanding of department policies, procedures and work instructions
  • Maintain daily, positive communication with other departments
  • Other duties as assigned



  • High school diploma or equivalent required
  • 3+ years of medical collections required, associate’s degree or higher may substitute for 2 years of experience
  • Excellent customer service and communications skills
  • Strong attention to detail
  • Ability to organize/prioritize workload
  • Innovative thinking/problem solving skills
  • Ability to develop and maintain positive working relationships
  • Proficiency with Microsoft Office required
  • Data entry
  • Experience working with a document imaging system
  • Experience working with RealMed and JD Edwards preferred
  • Experience working with high-dollar DME preferred
  • Previous experience working with government programs, including Medicaid and Medicare preferred
  • Strategic Skills
  • Courageous Leadership
  • Operations Mastery
  • People Skills
  • Energy & Drive      


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