Job Title: Revenue Cycle Specialist (Collections)

About Sutherland

At Sutherland, named a Great Place to Work, we care for our customers’ customers and help to strengthen their brands by improving how they interact with their customers to deliver an extraordinary customer experience. With over 35 years in business and nearly 40,000 employees across hundreds of companies in over 100 countries, we are dedicated to exceptional service.

Job Description

In this position, you will be responsible for handling a variety of tasks to ensure payment collection activity is resolved, disputed, or escalated to Legal. Key responsibilities include:

• Conducting collection activities on appealed claims by contacting government agencies, third-party payers via phone, email, or online.
• Providing ongoing, appropriate collection activity on appeals.
• Requesting additional information from Patients, Medical Records, and other sources as needed.
• Communicating with insurance plans and researching health plans for benefits and coverage types.
• Reviewing contracts and identifying billing or coding issues, requesting re-bills, secondary billing, or corrected bills as necessary.
• Handling other duties as assigned.

Qualifications

• Thorough understanding of the revenue cycle process, from patient access (authorization, admissions) through Patient Financial Services (billing, collections) procedures and policies.
• Full understanding of Managed Care collections.
• Familiarity with terms such as MMC, HMO, PPO, IPA, and Capitation, and how these payers process claims.
• Knowledge of Managed Care contracts, contract language, and Federal and State requirements.
• Intermediate understanding of Hospital billing form requirements (UB04) and HCFA 1500.
• Experience in medical claims and/or hospital collections.
• Minimum high school education, technical training, and/or other related experience.

Work From Home Requirements

We will supply equipment, but to work from home, you must have:

• Excellent Internet Connectivity:
• Speeds of at least 5 Mbps upload and 30 Mbps download (faster is better).
• A stable, in-house network with a hard-wired internet connection capable of supporting outstanding call quality and high-speed response rates. (Wireless and/or satellite internet service providers are not compatible with our systems).
• A quiet, distraction-free, and secure workspace.

Additional Information

IMPORTANT NOTE: This job is open only to residents of the United States. You must be authorized to work in the US to be considered for employment.

Equal Employment Opportunity:
Sutherland is an equal opportunity employer. We treat employees without regard to race, color, religion, sex, national origin, age, marital or veteran status, medical condition or handicap, or any other legally protected status. Periodic reports on employee demographics are made to government agencies for statistical analysis and compliance purposes. Completion of the EEO Record is voluntary and does not affect employment decisions.