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Sr. Collection Specialist

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POST DATE 9/2/2016
END DATE 11/2/2016

Cotiviti USA, LLC Conshohocken, PA

Conshohocken, PA
AJE Ref #
Job Classification
Full Time
Job Type
Company Ref #
Entry Level (0 - 2 years)
High School Diploma or GED



The Sr. Specialist, Collections position is responsible for recommending, developing and implementing processes in the support of collecting funds for the client and maintaining strong provider relations. Works closely with audit team, payers and providers; serves as a subject matter expert on claims and or concepts to facilitate effective communication and collection. Engages in verbal and written communication involving the provider, audit staff and client. Identify problems in the collection process for escalation to the appropriate parties.

Key Responsibilities

* Provides Enhanced Collections Support and Analysis. Provides expertise in collections support by reviewing, researching, investigating, negotiating and resolving collections issues for one or more accounts. Serves as a liaison between collectors and auditors on complex issues and or dispute resolution. Escalates sensitive issues to management as appropriate.

* Follows-up on Outstanding Claims. Follows established policies and procedures to collect identified claims. Communicate with providers and/or the client as appropriate to manage the recovery process of those claims.

* Provides Communication Expertise. Serves as a key point of contact and facilitates responses for more complex inquiries and data requests from both internal and external customers. Communicate directly with the client or providers as necessary following established processes and procedures.

* Investigates Claim Disputes. Investigates claim disputes as required. Identifies issues timely and escalate to appropriate parties. Provide accurate information, supporting documentation, and effective communication to complete recovery process.

* Document Activities utilizing established tools and systems. Maintains collection records and account status updates. Utilizes with increasing proficiency, proprietary reports, tools and systems required to perform duties.

* Leads Process Improvement Initiatives. Assists with developing solutions to improve the collection process.

* Meets or Exceeds Standards for Productivity. Maintains productivity goals and standards set by the department. Insures all department rules and processes are followed. Alerts manager of system issues or other issues impacting productivity.

* Meets or Exceeds Standards for Quality. Achieves the expected level of quality set by the department. Verifies completeness and accuracy of work. Alerts manager of issues or concerns impacting quality of work.


What we\'re looking for:

* High School graduate or equivalent education.

* At least 3+ years AR/Collections Experience required.

* 1 to 3+ years Medical Insurance background is required.

* 1 to 3+ years of customer service experience.

* Computer proficiency in Microsoft Office applications and system databases are required; ability to type at least 50 words per minute.

* Requires working knowledge of and applicable industry based standards.

* Excellent verbal and written communication skills.

* Ability to work well in an individual and team environment.

* We are an Equal Opportunity Employer.

* Please view Equal Employment Opportunity Posters provided by OFCCP here.

* Cotiviti is an Equal Opportunity Employer. The Company provides equal employment opportunities to all applicants for employment without regard to gender, sexual orientation or preference, gender identity or expression, race, color, religion, national origin, ethnicity, ancestry, age, marital status, pregnancy, childbirth or related medical conditions, mental or physical disability, veteran status or any other characteristic protected by federal, state or local law, ordinance or regulation..

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, or national origin. We are also an equal opportunity employer of individuals with disabilities and protected veterans. Please view Equal Employment Opportunity Posters provided by OFCCP here.