Required: Must have high volume medical collections experience
Position Summary:
The Collector serves as the account representative for resolving payments and accounts with insurance companies, government payors, and/or patients. They are responsible for completing assigned accounts within assigned work queues, maximizing reimbursement by evaluating claims at the contract rate, initiating appeals for underpayments, and handling payor and/or patient correspondence. The Collector also escalates accounts that need to be appealed, reports billing edits to supervisors, and has a strong understanding of the Revenue Cycle processes and managed care contracts.
Responsibilities:
Serve as the account representative for resolving payments and accounts with insurance companies, government payors, and/or patients.
Complete assigned accounts within assigned work queues.
Maximize reimbursement by evaluating claims at the contract rate.
Initiate appeals for underpayments and observe timely requirements.
Handle payor and/or patient correspondence in a timely manner.
Escalate accounts that need to be appealed due to improper billing, coding, and/or underpayments.
Report new/unknown billing edits to direct supervisor for review and resolution.
Have a strong understanding of the Revenue Cycle processes and procedures.
Have thorough knowledge of managed care contracts, payor rates, and Federal and State requirements.
Interpret Explanation of Benefits (EOBs) and Electronic Admittance Advices (ERAs) to ensure proper payment and educate patients and colleagues.
Understand hospital billing form requirements (UB04) and HCFA 1500 forms.
Knowledge of various payors and how they process claims.
Demonstrate knowledge of and effectively use patient accounting systems.
Document all calls and actions taken in the appropriate systems.
Accurately code insurance plan codes.
Establish payment arrangements for patients unable to pay in full.
Review applicable cash rates, special rates, and discounts.
Process bankruptcy and deceased patient accounts.
Perform other duties as assigned.
Required Skills & Experience:
One year of previous hospital business experience or equivalent, or strong background in customer service.
Basic experience with insurance plans, hospital reimbursement methodology, and/or ICD10 and CPT coding.
Required Education:
High school diploma or equivalent.
Wollborg Michelson Recruiting is an Equal Opportunity Employer and prohibits discrimination of any kind. We ensure job offers are made based of one's employment experience, skills, and qualifications, regardless of race, gender, ethnic origin, or any other classification protected by law. All applicants must furnish proper identification to prove their legal right to work in the US upon a job offer. We participate in E-Verify to confirm one's right to work in the US. Wollborg Michelson Recruiting does not provide sponsorship for an employment-based visa status. All applicants must also provide proof of COVID Vaccination when requested, except where prohibited by law.