Collections Specialist - Healthcare

The Finance Operations organization works with every part of Amazon to provide operations accounting and operations excellence services with the highest level of controllership at the lowest cost to the company. We provide the backbone systems and operational processes which completely, accurately, and validly pay Amazon's suppliers, invoice our customers and report financial results. Amazon is quickly building the Finance Operations capabilities in the healthcare industry by creating the Healthcare Finance Operations Services.

As part of the Amazon Healthcare Global Finance Operations Services team, you will find yourself working with exceptionally talented and determined people committed to driving financial improvement, scalability, and process excellence. To support the growth of Amazon HealthCare, this candidate must possess a strong passion for accountability, setting high standards, raising the bar, and driving results through constant focus on improving existing and future state operations, systems, and processes in collaboration with Senior Management.

The ideal candidate will not only have exposure to healthcare revenue cycle, including shared services functions (e.g. billing, collections, cash application) but also have exceptional customer obsessed skills to resolve complex dispute management and provide excellent customer service. They will be able to learn quickly and be willing to experiment with new ideas.

Key job responsibilities

• Reviewing and investigating claims processing, verifying the proper payment of claims, and bringing insurance claims to full resolution through a combination of external third-party relationships and cross-functional communication and collaboration.
• Maintaining service level agreements regarding assigned accounts receivable tasks while ensuring timely resolution of all claims while prioritizing responsibilities, problem solving, and thinking critically as you perform your regular duties and accommodate other time sensitive tasks as they arise.
• Conducts regular review and follow up of accounts receivables, ensuring the timely resolution and payment of accounts. Utilizing multiple reports and worklists, ensuring that all claims are adjudicated correctly per the member's benefits, investigating claims that do not process as expected or for which we do not receive a determination, all while adhering to all applicable guidelines.
• Design, develop, and implement process improvements to prevent denials and reduce internal processing errors.
• Develop resource material that is accessible and shared by the team and assist in the development of training materials for denial management. Assist in the training of new hires in AR
• Finding and resolving market trends with specific payors, escalating where appropriate while utilizing root cause analysis to develop appropriate action plans.
• Omission of specific duties does not exclude them from this position if the work is similar, related or a logical assignment for this position

Basic Qualifications

• Bachelor's degree in accounting and commerce (B. Com)
• Minimum experience of 4 years in Insurance Accounts Receivable in RCM space required
• Experience working in shared services environment with productivity targets
• Exposure to US healthcare and insurance landscape
• Experience with Medicare preferred
• Exceptional communication and interpersonal skills
• A proven track record of seeing projects through to completion, thorough follow through, and an ability to work independently with a strong attention to detail
• Proven ability to solve complex problems
• Driven to ask questions and find solutions
• Understanding of basic accounting principles and receivables management
• Proven ability to adhere to policies and procedures, as defined by leadership

Preferred Qualifications

• 4+ Years experience with US healthcare and health insurance industry
• Experience with Medicare preferred
• Prior experience of at least 2 years in Insurance Accounts Receivable in primary healthcare setting preferred
• Has led or been part of a team that worked on a Six Sigma belt project / Kaizen / Lean projects

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