The Patient/Medical Collection Specialists are responsible for all functions related to the collection of payment on patient accounts. This position obtains necessary verification insurance eligibility and collection of monies owed. This position works with management and other staff to identify and resolve issues that threaten billing and reimbursement. This will be in an office position.
Job Responsibilities
• Communicate directly with patients regarding their financial responsibility.
• Makes telephone, text, or letter contact with all patients with balances.
• Document all calls timely and accurately in the patients' account in the billing system.
• Runs reports on outstanding patient/self-pay A/R on a daily/weekly basis.
• Establish payment arrangements per company policy.
• Oversee the Hardship program and needs.
• Manage outstanding self-pay accounts.
• Contact insurance companies to check eligibility and benefits via phone or online portals.
• Updates patient demographics not including or limited to patient address, email, phone number, autopay, etc.
• Work the Patient Hub/AR dashboard.
• Assist with unidentified/unverified payments.
• Monitors collection agency report of payment on a regular basis.
• If it is determined that a refund is due to the insurance company and/or patient, complete refund-request form.
• Perform insurance claim follow-ups for insurance denials and appeals.
• Assist with other billing/collection duties, as needed.er accurate documentation and appropriate insurance for verification.
• Initiate authorizations and perform Key User duties with minimal errors.
• Resolve customer billing and payment inquires.
• Discuss payment arrangement options and provide the share of costs for Home Health Services.
• Accurately document the patient's insurance plan benefits and required authorizations.
• Coordinate with admission and scheduling departments to ensure timely patient care.
• Assist in gathering necessary reports, statistics, outcomes for the department and agency.
• Provide timely and effective customer service to patients and their representatives as needed.
Minimum Qualifications:
• High School Diploma or equivalent; Associates Degree preferred
• 2 years of office experience in medical billing / collections required
• Must possess knowledge of Explanation of Benefits (EOB's) and understanding of copays, coinsurance, deductibles and denial codes.
• Attention to detail and have the ability to prioritize independently
• Prior experience using IBM Compatible systems and equipment
• The ability to multi-task and in a busy office environment
• Proficient customer service skills
• Intermediate knowledge of MS Office
Physical Demands and Working Environment
The conditions herein are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job functions.
Environment: Standard office setting; tasks are regularly performed without exposure to adverse environmental conditions; frequent interaction with staff and the general public. The role requires that you wear a headset, access and work within multiple systems while addressing callers' concerns in real time.
Physical: Incumbents require sufficient mobility to work in an office setting; stand or sit for prolonged periods of time; operate office equipment including use of a computer keyboard; light lifting, carrying, pushing and pulling; ability to verbally communicate to exchange information.
Vision: See in the normal visual range with or without correction; vision sufficient to read computer screens and printed documents; and to operate assigned equipment.
Hearing: Hear in the normal audio range with or without correction.
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