Collector (Temporary)

Department:

Business Office

Reports To:

Business Office Supervisor/Manager

Organizational Peers:

Business Office Staff

Job Supervisory Responsibilities:

None

General Summary:

A nonexempt position responsible for the proper and timely processing of claims creation.

Essential Job Responsibilities:

• Process electronic and paper claims.
• Analyze outstanding balances to determine appropriate course of action.
• Trace and appeal underpaid, and/or erroneously paid or denies claims with appropriate documentation per payer requirements.
• Verify and adjust accounts according to payer or program specifications.
• Perform collection actions and resubmitting claims to insurances after corrections to minimize days in A/R.
• Accurately document claim issues.
• Prepare adjustments such as refunds, contractual differences, and write-offs for approval and processing.
• Audit, communicate and follow up with providers and staff to provide guidance in correcting errors related to denied or unpaid claims on continual basis.
• Assist staff with billing questions.
• Identify and resolve issues with patient/payer billing issues and complaints.
• Tracy new provider payer credentialing status and related claims.
• Review accounts for possible assignment to collections; make recommendations to Revenue Cycle Manager and prepare information for collection agency.
• Assigns uncollectable accounts to collection agency or attorney via clinic credit and collection policy.
• Review follow and report monthly, the status of delinquent accounts
• Continually strive to promo0te and maintain exceptional internal and external customer service.
• Monito pater websites for medical policy benefit changes. Communicate changes to supervisor and related staff.
• Review bulletins, newsletters and periodicals and attend workshop to stay abreast of current issues, trends and changes in laws and regulations governing claims, processing, coding and documentation.
• Provide suggestions to improve daily collections workflow and inefficiencies.
• Demonstrate working knowledge of ICD-9, CPT and HCPCS codes along with HIPAA laws.
• Comply with all written and stated company policies and procedures.
• Provide back up and support to team members as necessary.
• Work projects as assigned by management.
• Other duties as assigned.

Performance Requirements:

Knowledge:

• Working knowledge of ICD-10, CPT and HIPAA laws.
• Knowledge of company medical billing/collection policies and procedures.
• Knowledge of legal and regulatory government provisions.
• Knowledge of business and communication software.

Skills:

• Skill in establishing and maintaining positive, effective, internal and external working relationships.
• Skill in written and verbal communication and organization.

Abilities:

• Ability to multitask.
• Ability to accurately enter data and examine insurance documents.
• Ability to courteously work with patients, staff, and others.
• Ability to communicate well and interact in a positive manner with management, coworkers and payers effectively and clearly.

Position Competencies:

• Role model for organization’s core values
• Customer Service: Demonstrates the highest standards for friendly, courteous and caring interaction with patients, physicians, customers, and fellow employees.
• Analytical
• Organization and presentation abilities
• Professional presence
• Communication: Demonstrates ability to accept and understand instructions, expresses self clearly and concisely.
• Adaptability/Flexibility: Demonstrates the ability to cope with pressure, grasp new ideas and methods, and adjust responses to meet the changing work environment.
• Independence/initiative: Demonstrates reliability, follow through, ability to work with minimum supervision, and desire and ability to accept additional responsibility.
• Confidentiality
• Emotional Intelligence: Maintain basic emotional and social competencies to include self-awareness, self-regulation, motivation, empathy, and social skills.

Job Qualifications:

• Equipment operated: Standard office equipment including computers, faxes, copiers, printers, telephones, etc.
• Education/Experience: High school diploma or equivalent. Some college, knowledge of medical terminology, system and ICD-10 preferred. Minimum of two years medical collections experience.
• Physical: Position is in a well-lighted office environment and involves sitting approximately 90 percent of the day, walking or standing the remainder.