Doctor's Hospital at Renaissance
Harlingen, United States
Permanent | Full Time
POSITION SUMMARY:This position is responsible for activities leading to the collection of accounts receivable that are outstanding on the ATB, utilizing verbal and written communications with insurers, providers, employers, patients and other payers. This position requires being familiar with patient, commercial, workers compensation, and liability third party payer reimbursement, and is accounspan for getting those accounts collected.POSITION EDUCATION/QUALIFICATIONS:* High school diploma/ GED is required* Comprehensive knowledge of healthcare reimbursement* Understands medical terminology* Knowledge of Microsoft Office suite, working knowledge of Excel required* Excellent Customer Service* Good written and verbal communication skills required.* Must be able to multi-task* Ability to read, write and speak English.* Ability to communicate clearly and concisely with all levels of management* Previous healthcare experience (1-2 yrs.) is required, hospital experience preferred.JOB KNOWLEDGE, SKILLS, AND EXPERIENCE:* Minimum of 1-2 yrs. experience with medical collections, managed care contract experience is preferred.* Communicates clearly and concisely and is able to work effectively with other employees, patients and external parties* Provides excellent customer service by establishing and maintaining long-term relationships with carrier reps.* Demonstrates proficiency in Microsoft Office applications, be able to type at least 35 WPM, and good working knowledge of Excel is required.* Able to perform basic mathematical calculations, balance and reconcile figures, punctuate properly and spell correctly.* Ability to use the internet to obtain claim status with Third Party Payers.* Requires working with minimal to moderate interruptionsPOSITION RESPONSIBILITIES:* Promotes the facility mission, vision and values by effectively communicating them to others. Considers mission, vision and values in developing services, standards and practices* Responsible for following up insurance accounts assigned on ATB report and Tickler report* Contacts insurance carrier for payment on assigned accounts* Follows-up on an accounts daily and completes 100% of the assigned accounts by the end of each week.* Adheres to collection tips booklet when contacting insurance carrier.* Proficient in accessing information from revenue cycle software* Reviews accounts to ensure the appropriate insurance plan is set-up and the correct insurance adjustment was posted.* Reads previous notes on the account and document new notes using appropriate mnemonic in the notes tab* Familiar with managed care contract terms to determine appropriate reimbursement of insurance carrier* Ability to compare the payer reimbursement to the expected payment in the computer and question any discrepancies with insurance carrier when on the phone* Ability to identify accounts that need insurance billing or rebilling i.e., late charges* Contacts physician's office and request copies of documentation needed* Request copies of medical records from HIM for any paper records as needed* Ability to obtain electronic records from the Cerner system as needed* Contacts patient to ensure all requested information for insurance company is provided.* Daily follow up on faxes or messages to carriers within 24 hours, to ensure the fullest collection effort is accomplished.* Provide excellent customer service by responding to carriers or patient calls within 24 hours and documents activity on the patient account.* Assist other collectors in collecting a difficult account as needed* Select correct adjustment codes on letter to appropriately document reason for adjustment* Provide assistance with the Customer service front desk, as needed.* Assign appeal agency code to the accounts that need to be followed up by the appeals area.* Complete adjustment form appropriately with the correct dollar amounts assigned to the codes* Responsible to complete all tasks assigned daily.* Ensures patient confidentiality requirements are met in accordance with HIPAA policies and procedures.* Other duties as assigned.
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