Role Description In this position, you will be responsible for handling a variety of tasks to ensure payment collection activity is resolved, disputed or sent to Legal. This will include:

• Conducting collection activity on appealed claims by contacting government agencies, third party payers via phone, email, or online.
• Providing ongoing appropriate collection activity on appeals.
• Requesting additional information from Patients, Medical Records, and others as needed.
• Communicating with insurance plans and researching health plans for benefits and types of coverage.
• Reviewing contracts and identifying billing or coding issues and requesting re-bills, secondary billing, or corrected bills as needed.
• Handling other duties as assigned.

Qualifications

• Thorough understanding of the revenue cycle process, from patient access (authorization, admissions) through Patient Financial Services (billing, collections) procedures and policies.
• Full understanding of Managed Care collections.
• Familiarity with terms such as MMC, HMO, PPO, IPA and Capitation and how these payers process claims.
• Knowledge of Managed Care contracts, Contract Language and Federal and State requirements.
• Intermediate understanding of Hospital billing form requirements (UB04) and HCFA 1500.
• Medical claims and/or hospital collections experience.
• Minimum high school education, technical training, and/or other related experience.

Requirements

• Excellent Internet connectivity:
• Internet access speeds of at least 5 Mbps upload and 30 Mbps download – the faster the better!
• In-house network, and a hard-wired Internet connection capable of continuously supporting outstanding call quality and high-speed response rates. (wireless and/or satellite Internet Service Providers are not compatible with our systems).
• A quiet and distraction-free, secure place to work.

Additional Information

• IMPORTANT NOTE: This job is open only to residents of the United States, and you must be authorized to work in the US in order to be considered for employment.
• EEOC and Veteran Documentation: During employment, employees are treated without regard to race, color, religion, sex, national origin, age, marital or veteran status, medical condition or handicap, or any other legally protected status.
• At times, government agencies require periodic reports from employers on the sex, ethnicity, handicap, veteran and other protected status of employees. The purpose of this Administrative EEO Record is for statistical analysis only and is used to comply with government record keeping, reporting, and other legal requirements.
• Periodic reports are made to the government on the following information. The completion of the Administrative EEO record is optional. If you choose to volunteer the requested information, please note that all Administrative EEO Records are kept in a Confidential File and are not part of your Application for Employment or Personnel file.
• Please note: YOUR COOPERATION IS VOLUNTARY. INCLUSION OR EXCLUSION OF ANY DATA WILL NOT AFFECT ANY EMPLOYMENT DECISION.