Job Description

This is a Remote position

About Zealie

Zealie is a fast-growing Medical Billing Services company specializing in the Behavioral Healthcare industry. Our clients are substance use disorder treatment, addiction recovery, and mental health treatment centers that are saving lives on a daily basis. Our state of the art proprietary technology provides data analytics and revenue prediction tools to our clients to help them make strategic business decisions to grow their business. We are committed to delivering exceptional products and services to our clients and believe that our Collections team plays a crucial role in achieving this mission. We are seeking motivated individuals with a desire to be a part of a winning team.

Job Summary

Under the supervision of the Collections Team Lead, the Collections Specialist is responsible for administrative tasks and collection of outstanding account receivables and all other aspects of collections, analysis and resolution of billing problems. All work remains internal, and not client facing. Collections Specialists will not respond to Clientele, nor join Client meetings, unless otherwise discussed with their Supervisor(s).

Responsibilities and Duties

Receive daily assignment from Team Lead, and work assigned accounts within the allotted time frame Enter all insurance payments received by ensuring data is correctly entered into the Billing Logs Make calls to carriers regarding status of claims and payments Review and research denials and partial payments Status Claims in an effort to reprocess any claim that is delayed in payment (ie. rejected, denied) Meet or exceed Zealie's standard of Call to Portal Ratio (50/50) Review Payment Information and confirm its accuracy Review Correspondence daily & make appropriate changes in the client's Log Review Third Party Administrator offers daily; coordinate with Team Lead and Manager as to what is offered, requesting feedback; respond to the TPA accordingly; make appropriate changes in the Logs, and save files to the Forward Folder accordingly Utilize the tools Zealie offers to make informed decisions when working a stagnant claim, and provide a full picture of the issue at hand to their immediate supervisor where necessary Report to immediate supervisor if work is unable to be completed in a timely manner Report to immediate supervisor if work is finished early and there is time available for additional claims to be assigned Adhere to the Collections Department Standard Operating Procedures Submit a copy of your Production at the end of each day for your Team Lead and Quality Compliance team's review Receive routine constructive feedback from your supervisor(s) and/or QC regarding quality and quantity of work completed, considering both the Standard Operating Procedures and working knowledge of this industry Continually adapt to process improvement for the betterment of Zealie and its Clientele Perform additional duties as requested by direct Supervisor and/or Management

Qualifications and Skills

Excellent organizational skills Ability to successfully navigate private insurance denials for proper adjudication Ability to navigate Payer Portals to verify eligibility, claim status, and remittance details Ability to read and understand an Explanation of Benefits (EOB) Effective communication skills, both verbal and written via phone and email Proficiency utilizing Electronic Health Record Systems & Billing Software such as Kipu, ZenCharts, BestNotes, SunWave, CollaborateMD. Proficiency in Google Products including Google Workspace, Google Drive, Google Sheets, Google Docs Ability to navigate various technology and software tools such as Zoom, eFax software, Adobe, Systweak

Education and Experience:

Minimum of 3-5 years of experience in the Collections / AR process, with demonstrated expertise in handling complex cases. High School Diploma, Senior School Certificate, or the equivalent.

(Preferred):

Quality Score of 96% or above Experience working in a behavioral health billing setting Experience working in Substance Abuse/Mental Health Treatment Industry Experience statusing 50+ claims per day Experience reviewing insurance correspondence * Comprehensive knowledge of all levels of care (Detox, RTC, PHP, IOP, OP, Aftercare)