Evolve Treatment Centers offers cutting-edge intensive outpatient, partial hospitalization, and residential programs for teens ages 12 to 17 struggling with substance use and mental health disorders. We use evidence-based treatment modalities, including Dialectical Behavior Therapy (DBT), Cognitive Behavior Therapy (CBT), and Motivational Interviewing (MI), as well as several experiential therapies. The Associate Therapist training program provides a unique opportunity for clinicians to gain experience working with teens facing acute mental health issues, as well as understanding residential and intensive outpatient settings.

The Collections Specialist helps accomplish company goals by providing resolution and service to outstanding receivable accounts. The ideal candidate has the passion and drive, intelligence and integrity, high attention to detail, professionalism and excellent follow up skills to increase revenue.

The position requires a thorough knowledge of the healthcare industry and have an assertive, effective strategy when working with insurance carriers to get claims paid.

Job Responsibilities and Duties:

• Patient Advocate/Parent Follow Up – Daily
• Paid to Patient/Paid to Deductible/Private Pay – follow up weekly
• Certified Mail package preparation– once/twice a week
• SCA (Single Case Agreements)
• Provides claim resolution for assigned accounts to increase collections and reduce delinquencies
• Analyzes Explanation of Benefits and Remittance Advices and ensures claims processed according to members plans
• Identifies denial reasons, and follows appeal process to get claims paid
• Performs high volume collection phone calls to insurance companies
• Access payer online resources to expedite claims follow up and ensure claims are on file and processing
• Follows EOB protocol, retrieve documentation to ensure paid accounts are closed
• Accesses billing software to analyze rejection reasons and communicate findings
• Communicates billing/coding errors and completes resubmission request
• Identifies and reports changes and trends in carrier guidelines and reimbursement patterns
• Executes and delivers special projects from management and other duties as assigned
• Corresponds with third party rate negotiation companies to expedite claim process
• Accesses EMR, retrieves medical records and prepares for submission while following protocol
• Adheres to documentation protocol, notates accounts and reports appropriately
• Organizes daily and weekly production/action reports in file share
• Participates in companywide and departmental meetings
• Commits to providing excellent customer service while maintaining the highest degree of professionalism while working in a team environment to meet goals
• Understands and complies with all HIPAA rules and regulations
• Office/Facilities and any other duties as assigned.

• Experience working in Healthcare as Collections Specialist specially Behavioral claims collection.
• 3-5 years High Volume corporate Collections experience
• Knowledge of Billing and Collections procedures
• Experience working with online payer resources
• Excellent Customer Services
• Experience speaking with Payors
• Experience speaking with families, parents etc. and collecting money
• Accounts Receivable knowledge/experience
• Strong attention to detail, goal oriented
• Commitment to excellent customer service
• Ability to work efficiently within deadlines
• Excellent written and verbal communication abilities
• Strong interpersonal skills and ability to work in a team environment.
• Ability to prioritize and manage multiple responsibilities.
• Adheres to all policies and procedures as outlined in the Employee Handbook
• Proficiency using Microsoft Office products

For information on Evolve's privacy practices, see the Evolve California Personnel Privacy Notice located at https://evolvetreatment.com/personnel-privacy-notice/.