General Summary: The Collector is responsible for ensuring the prompt and proper payment of claims and contacting the appropriate entity or individuals if payment is not made in a timely manner.
Patient Population: Does not have contact with patients.
1. Processes and follows-up on third party collections. Reviews their party aging and follows-up on outstanding claims.
2. Contacts insurance companies, patients, government agencies, other hospital departments, physician offices, attorney offices and other third party payers on aged and past due balances.
3. Reviews and follows-up on Explanation of Benefit denials.
4. Submits re-bills, tracers, and appeals; submits adjustments using appropriate reason code classifications. Identifies bad debt accounts for adjustment and identifies credits and refunds.
5. Performs collection duties, rebilling research, correspondence, returned mail and problem solving of account billing errors.
6. Verifies billing information for electronic claims transmission and hard copy billing. Follows-up on accounts billed both electronically and manually.
7. Reviews remittance advice forms to verify proper reimbursement and make adjustments as necessary.
8. Verifies coding with claims processors at third party payer companies regarding disputes/denied claims and follows-up on all bills not processed within usual claim period.
9. Regular attendance and timeliness is required.
This description is a general statement of required essential functions performed on a regular and continuous basis. It does not exclude other duties as assigned.
Supervision: Does not direct the activities of the staff.
Experience: Two years medical insurance and hospital collections experience required; Insurance claims processing experience a plus. Knowledge of appeals process required. Ability to work in a fast-paced, high call volume environment strongly desired. Excellent communication and customer service skills required.
Education: High school diploma or equivalent required.
- 3 years ago - save job