Medical Collector

The medical billing and collection specialist is responsible for ensuring accurate billing, timely submission of electronic and/or paper claims, monitoring claim status, researching rejections and denials, documenting related account activities, posting adjustments and collections of Medicare, Medicaid, Medicaid Managed Care, and commercial insurance payers. The medical billing and collection specialist must possess critical thinking skills and understanding of Medicare, Medicaid eligibility requirements as well as commercial insurance payer payment methods to correctly record contractual adjustments base on payer contracts or government regulations. In addition, the medical billing and collection specialist must demonstrate proficiency with billing system to ensure all functionality is utilized for the utmost efficient processing of claims to Insurances nationwide.

Accountabilities:

•        Responsible for charge and payment entry within Electronic Health Record. Coordinates and clarifies with clients/customers, when necessary, on information that seems incomplete or is lacking for proper account / claim adjudication.

•        Responsible for correcting, completing, and processing claims for all payer codes.

•        Analyze and interpret the claims are accurately sent to insurance companies.

•        Perform follow up with Medicare, Medicaid, Medicaid Managed Care, and health insurance companies on unpaid insurance accounts identified through aging reports.

•        Able to identify and appeal claims if needed and or ability to process appeals online or via paper submission; Assist with billing audit related information.

•        Attends customer meetings/ workshops / implementations when needed.

•        Ability to navigate commercial/customer payment platforms and or portals.

•        Other duties and projects as assigned by management.