Medical Billing Collection Specialist

A Medical Billing Collection Specialist typically works for a hospital, medical office or medical collection agency to collect on past due accounts.

Nature of the Work

A medical claims and billing specialist prepares and submits medical insurance claims to insurance companies to collect covered expenses after a patient received medical care. If any claims are denied, the collections specialist follows up to resolve any questions, then bills the patient for the balance.

In addition, the collection specialist fields questions from patients, staff, and insurance companies, and resolves any billing disputes.

A medical billing specialist will spend a lot of time talking with insurance companies and fielding questions from patients, resolving any errors or discrepancies, and making sure all billing and accounting records are accurate.

A medical collections specialist will spend a large amount of their time dealing with accounts that are past due and will be dealing with patients that are often reluctant or incapable of paying. Collections specialists are often be required to work nights and Saturdays when patients are easier to reach.

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Training and Qualifications Needed For a Medical Billing Collection Specialist

A high school diploma is required for most entry-level jobs, although many employers prefer at least some college work. Knowledge of ICD-10 & CPT-4 coding is often expected although some employers may provide on the job training. In addition, a working knowledge of medical and insurance terms is desirable.

Strong verbal and communication skills are critical, as successful medical billing collection specialists must deal with both insurance companies and patients in a clear, concise manner.

Because many of these past due accounts are a direct result of an illness, the ability to be sensitive to the patient's situation as they work with individuals to come up with a plan for repayment is a must.

Opportunity for Advancement

A typical career path might consist of starting off as a medical billing clerk at a doctor office then after a few years of experience might progress to office manager. Another possibility is to work for a large medical clinic or hospital and work your way up to billing supervisor.

You may also consider using your medical collections experience to work for a collections agency that specializes in medical collections or potentially open your own medical billing or collections agency.

Long Term Job Outlook

With the healthcare industry continuing to grow as the population ages, opportunities in medical billing collection will also increase at a more rapid pace than generally industry making it a solid career avenue for many years to come.

Salary and Earnings Potential

The average salary for medical billing collection specialists in the US is around $38,000, with the bottom 10% around $25,000 and the top 10% around $62,000. Variations in geographical location and experience account for the differences.

› Medical Billing Collection Specialist

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