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Collections Specialist ASC - USHWY 290

Austin Regional Clinic • Manor, TX • 17h ago

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ASC Collections Specialist

Job Category

Office and Clerical

Requisition Number

COLLE008943

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Posting Details

Posted:

December 9, 2025

Full-Time

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Locations

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Job Details

Description

ABOUT AUSTIN REGIONAL CLINIC:

Austin Regional Clinic has been voted a top Central Texas employer by our employees for over 15 years! We are one of central Texas largest professional medical groups with 35+ locations and we are continuing to grow. We offer the following benefits to eligible team members: Medical, Dental, Vision, Flexible Spending Accounts, PTO, 401(k), EAP, Life Insurance, Long Term Disability, Tuition Reimbursement, Child Care Assistance, Health and Fitness, Sick Child Care Assistance, Development and more. For additional information visithttps://www.austinregionalclinic.com/careers/

PURPOSE

Performs all duties required to accurately monitor and resolve unpaid, denied or underpaid claims, post payments and appropriate adjustments, and assist patients with billing inquiries and follow up on unpaid patient balances. Carries out all duties while maintaining compliance and confidentiality and promoting the mission and philosophy of the organization.

ESSENTIAL FUNCTIONS

Claims Resolution

Denial Follow Up work queues:

Takes timely and appropriate follow up action on denied claims based on the X12 CARC/RARC Reason Code and payor policies/statutes. Either submits corrected claims, prepares reconsiderations or appeals, performs accurate adjustment actions, or assigns financial responsibility to the next responsible party in accordance with company policy.

Collaborates with ASC Billing Specialist to obtain coding reviews and prior authorization corrections for reconsiderations and appeals.

Communicates with facility staff when necessary to obtain information to edit claim data, and other assistance with follow-up and/or appeal actions.

Edits claims through Correct/Repost actions to reflect complete, accurate and updated information on replacement claim, when necessary.

Accurately documents issues, sources, and actions taken to describe activities and results in the Follow-up Activity sidebar.

Prepares and submits medical necessity appeals together with the supporting documentation in accordance with payor policy.

Zero Response Work Queues:

Utilizes payor websites and other resources for claims status on unpaid claims aged 30+ days. When necessary, requests missing EOBs or payments.

Responds to payor correspondence in a timely manner and documents follow-up actions.

Meets department productivity standards.

Interprets managed care contracts and fee schedules to ensure claims are processed correctly.

Submits adjustments to ASC Billing Manager for approval and processing, via work queue actions.

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