Collector

Under the supervision of the Director of Revenue Cycle, or designee, performs patient account insurance follow-up, credit balance review and resolution, keeping the hospital's accounts receivable as accurate as possible.

Responsibilities:

• Review claims on-line as offered by individual payors to ensure timely processing.
• Contact insurance carriers by phone regarding outstanding balances, as needed.
• Resubmit claims to insurance carriers, as needed.
• File appeals on technical denials and/or claim disputes, as needed.
• Validate accounts for accurate payments, discounts, and contractual adjustments, correcting them, as needed.
• Reply to insurance carrier correspondence in a timely matter.
• Answer in-coming calls resolving insurance issues in a timely matter.
• Credit Balance Process and Review, as assigned.
• Review all credit balance accounts for incorrect contractual adjustments, correcting them as needed.
• Respond in writing to insurance companies' refund requests in a timely matter to avoid inappropriate recoupments.

Qualifications:

• High school diploma or equivalent.
• One to two years' experience in healthcare receivables.
• Must have a strong credit and collection background.
• Working knowledge of HMO, PPO, Commercial, and Workers' Compensation reimbursement.
• Working knowledge of Managed Care contract language and interpretation.