Collector, CBO

POSITION SUMMARY:

The Representative Accounts Receivable III is responsible for follow up on intermediate outstanding accounts receivable.

Work Schedule: Remote

ESSENTIAL RESPONSIBILITIES:
Follow-up on outstanding claims and appeals
Work escalation views
Review Vendor Clarification logs
Provide employee and vendor training
Acts as a knowledge resource for team members
Not limited to working Claim Ack Rejections, Claim Edits & Charge Corrections
Phone patients for payment or payment arrangements
Print and re-file claims as needed.
Work correspondence daily.
Maintain continuing education, training in industry career development
Exceed productivity standards as outlined by business line
Answer incoming patient insurance company and physician office telephone calls.
Research/audit patient accounts for further payment or adjustments.
Work KAM reports as assigned.
Work accounts receivable collector queue with proficiency within 30-60 days of employment.
Work 40-50 accounts daily with > or =90% accuracy rating; meet department productivity standards.
Calculate billing unties and reimbursement amounts.
Maintain strictest confidentiality and adhere to all company policies and procedures.
Other duties as assigned
Reads and abides by the company’s code of conduct, ethics statements, employee handbook(s), policies and procedures and other corporate mandates, including participation in mandatory training programs
Reports any real or suspected violation of the corporate compliance program, company policies and procedures, harassment or other prohibited activities in accordance with the reporting policies of the company
Obtains clarification of policy whenever necessary and may use the resources available through the Compliance, Human Resources or Legal Department to do so
Support and abide by the values of the company
Excellence – Going above and beyond to deliver the highest quality care and experience to our patients and teammates
Collaboration – Being inclusive and supportive of one another to deliver improved outcomes to our patients and teammates
Ethical Responsibility – Acting with the utmost integrity and doing the right thing, even when nobody is watching
Engagement – Promote an environment where clinicians and teammates thrive, feel passion and joy for what they do, take care of each other, and are proud of who we are and what we do.

QUALIFICATIONS:

To perform this job successfully, an individual must be able to perform each essential responsibility satisfactorily. The requirements listed below are representative of the knowledge, skills and/or abilities required.

Working knowledge of CPT, ICD-9 and ASA codes
Strong mathematical, research, analysis, decision making and problem-solving skills.
Strong data gathering and reporting skills.
Working knowledge of medical terminology, insurance processing guidelines and laws.
Demonstrates advanced understanding of commercial, Medicare and Medicaid payers
Working knowledge of TWCC guidelines and laws, commercial managed care insurance, Medicare and Medicaid guidelines.
Strong interpersonal skills and comfortable working with physicians, external customers, hospital staff, co-workers and senior leadership.
Strong verbal and written communication skills
Team oriented, must have a pleasant disposition and high tolerance level for diverse personalities.
Ability to work independently with limited supervision.
Demonstrates advanced understanding of claim needs and ability to accurately perform needed billing activities (Evaluation/Correction of billing edits, claim transmission, rejections, and other claim functions)

Education/Experience:

High School graduate or equivalent.
3 to 5 years’ experience in a healthcare insurance receivables environment
Associate or bachelor’s degree in business administration or related field preferred
Two - three years collection experience required.
Two years posting, coding or accounts receivable collection experience in health care organization is preferred.

Computer Skills:

To perform this job successfully, an individual should have knowledge of:

Microsoft Office Suite
Working knowledge of PC applications (MS Office, Word and Excel).