General Statement of Job
This position performs prompt follow up and collection of unpaid balances and by providing prompt response to telephone inquiries from patients, physician staff, insurance companies and other outside agencies. Employees in this position are responsible for following up on denied or returned insurance claims. The employee performs collection duties in accordance with all applicable state and federal collection regulations and compliance standards while maintaining a professional manner at all times
Performs work with aged listing of accounts via letters and phone calls.
Receives payments and posts amounts paid to patients’ accounts.
Researches reasons for non-payment and acts as the primary problem solver.
Takes appropriate actions on all unpaid claims to secure payment arrangements from the insurance company and guarantors.
Identifies and processes charity applications as needed.
Communicates with insurance companies, doctors, lawyers, and other payers to resolve unpaid claims.
Responds to patients and other third party telephone inquiries. Routes communications to appropriate personnel for further assistance as needed.
Performs secondary billing procedures after primary insurance is paid.
Makes recommendations to supervisor for collection agency placement on delinquent accounts.
Monitors payment plans for prompt payment.
Reviews insurance remittances to ensure accurate payments; resubmits or appeals as necessary.
Advises patients of necessary actions and strategies for debt repayment.
Maintains knowledge of the requirements and regulations of specific insurance carriers and corresponding insurance forms.
Recognizes coding problems and initiates resolution with records or billing staff.
Pursues professional development goals through continuing education and involvement as required.
Participates in work teams and departmental special projects as needed.
Performs accurate and timely patient account maintenance in the appropriate billing software.
Checks explanation of benefits on account payments for either a write off or to be referred to another collector for secondary billing.
Submits corrected claims due to credit balances.
Cross-trains in other functions for the department as needed.
Maintains accurate productivity records in accordance with operating procedures.
Performs general office clerical work including, but not limited to, copying files, entering data and answering phones.
Attends and participates in department staff meetings.
Maintains patient confidentiality at all times.
Documents and reports any complaints from patients/visitors/physicians to supervisor.
Performs Initial billing to Insurance companies using the hospital billing system or Medicaid Web Portal as needed or required.
Emergency duty may be required of the incumbent that includes working in special needs or Red Cross shelters or to perform other emergency duties including, but not limited to, responses to threats or disasters, man-made or natural.
High School Diploma or GED required.
Two (2) to three (3) years Accounts Receivable experience required.