Accounts Receivable, Billing Records, Communication Skills, Credit and Collections, Documentation, Electronic Medical Records, Google Apps, HIPAA (Health Insurance Portability and Accountability Act), Healthcare, Healthcare Reimbursement, Information/Data Security (InfoSec), Insurance, Insurance Documentation, Medical Record System, Microsoft Office, Organizational Skills, Problem Solving Skills, Research Skills, Spreadsheets, Time Management
Description
Job Summary:
Responsible for increasing third-party collections and decreasing the accounts receivable aging using effective and efficient collection techniques, including reaching out and forming relationships with designated payors. Must be able to understand and interpret Explanation of Benefits (EOBs) and Remittance Advices (RAs). Expected to have knowledge of insurance and billing forms and to have the ability to investigate and resolve third-party balances.
Essential Functions:
- Use problem-solving skills to research and resolve discrepancies, denials, appeals, and collections
- Initiate inquiries to health insurers and/or patients to resolve reimbursement and coverage issues
- Follow up with payers to ensure the timely resolution of all outstanding claims
- Send appropriate appeals, accurate requesting information, supporting documentation, and effective communication to complete the recovery process
- Form relationships with designated payors, and keep a list of contacts to aid in the recovery process
- Perform special projects and other duties as needed. Assists with special projects by utilizing Excel/Google spreadsheets, and the ability to communicate results
- Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.
- Other duties as assigned by the management team
Essential Qualifications
Experience Required:
This position requires a minimum of 1+ years of experience in healthcare third-party collections settings associated with claim data and claim production, as well as account follow-up and denial processing.
Education/Licensure/Certification Required:
- High School Diploma or GED
Education/Licensure/Certification Preferred:
- CPC or CPC-A, or equivalent
Skills Required:
Strong understanding of and ability to use software and systems, including, but not limited to, electronic medical record systems, Microsoft Office, and Google Docs/Sheets; daily use of laptop for email, note-taking, and other tasks required.
Job or State Requirements
High School Diploma or GED