- Primary functions are credit balance management, patient balance resolution and non-patient (insurance) resolution
- Accurate and timely follow up and resolution for all accounts receivable.
- Meeting and maintaining cash collection metrics and goals.
- Maximize facility reimbursement.
- Understand each payer contract and utilize to ensure payments received are correct.
- Understand and explain the Explanation of Benefits received from any payer.
- Work closely with payer provider relations representatives.
- Handle contracted and non-contracted; HMO, PPO, EPO, POS, Worker’s Com., self-pay and third party reimbursement issues.
- Effectively and independently handle second level reimbursement issues, contracted and non-contracted denials for serviced before and after procedures.
- Work all denials and corrected claims collaborating with the biller and/or Business Office Manager, insurance payers and/or patients on past due accounts.
- Follow center policies, procedures, and best practices for resolution and reassignment of accounts. Possess basic knowledge of medical terminology and health insurance billing.
- Have ability to communicate effectively with patient, physicians, and other teammates.
- Two or more years of experience in medical collections
- HS Diploma
- Excellent communication skills
- Ability to work in a fast paced environment
- Must be able to work independently