Negotiations Specialist

Department: RCM: Revenue Optimization & Operations

Employment Type: Full Time

Location: Headquarters - Matawan

Compensation: $20.00 - $30.00 / hour

Description

Summary of Responsibilities

• Manage the collections process for negotiated claims, following up on unpaid claims, invoices, and patient balances. 
• Utilize revenue cycle management software and tools to track and prioritize collection activities, ensuring timely and accurate follow-up. 
• Review and analyze unpaid claims and denials, identifying the root causes and taking appropriate actions for resolution. 
• Contact patients, insurance companies, and other payers to discuss outstanding balances, resolve billing discrepancies, and negotiate payment arrangements. 
• Maintain accurate and up-to-date records of collection efforts, communications, and payment arrangements in compliance with legal and organizational requirements. 
• Collaborate with billing and coding teams to ensure accurate and timely submission of claims and invoices for reimbursement. 
• Stay updated with insurance industry regulations, billing guidelines, and reimbursement policies to maximize collections and minimize denials. 
• Provide support and assistance to patients in understanding their insurance coverage, explaining billing statements, and addressing their financial concerns. 
• Work closely with the finance department to reconcile payments received, identify posting errors, and ensure accurate accounting of collections. 
• Generate reports and provide regular updates on collection metrics, aging accounts, and potential revenue risks to the revenue cycle management team. 

• High school diploma or equivalent. Associate's or bachelor's degree in healthcare administration or a related field is preferred. 
• Proven work experience as a Collections Specialist in a healthcare or clinical back office setting, with a focus on revenue cycle management. 
• In-depth knowledge of medical billing and coding processes, insurance claim submission, and reimbursement procedures. 
• Familiarity with insurance industry regulations, billing guidelines, and compliance requirements, including HIPAA. 
• Proficiency in using revenue cycle management software and tools to manage collections activities, track accounts, and generate reports. 
• Strong understanding of healthcare reimbursement methodologies, including commercial insurance, Medicare, and Medicaid. 
• Excellent communication and negotiation skills, with the ability to interact professionally and empathetically with patients, insurance companies, and other stakeholders. 
• Detail-oriented mindset, with the ability to review and analyze complex billing statements, claims, and denials. 
• Strong problem-solving skills, with the ability to identify billing discrepancies, resolve disputes, and find solutions to payment challenges. 
• Ability to work independently, manage multiple priorities, and meet deadlines in a fast-paced clinical back-office environment. 

• Full-Time
• Monday-Friday
• Remote

• 401(k) matching
• Medical, Dental & Vision
• Paid Time Off
• Sick Time
• Paid Holidays