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Hospital Senior Collections Representative
2 months ago
Description
The Hospital Senior Collections Representative manages a specific portfolio of inpatient and outpatient claims to maximize collection outcomes. Key responsibilities include:
*Conducting comprehensive and strategic account reviews.
*Leading efforts to resolve reimbursement discrepancies with third-party payers.
*Implementing proactive follow-up strategies to expedite account resolution.
*Communicate with insurance providers, patients, and internal departments to gather crucial information and address payment challenges promptly and efficiently
*Optimize account management efficiency and ensuring timely resolution within the revenue cycle, driving the organization's financial success.
Salary Range: $32.24/hour - $46.29/hour
Qualifications
We are seeking a self-directed, detail-oriented individual with:
*High school diploma or General Education Diploma (GED).
*Five or more years of progressive experience in collections, including extensive expertise in complex collections investigations and resolution.
*Thorough understanding of UB04 requirements and advanced knowledge of medical billing processes.
*Ability to interpret and apply payer contracts, skillfully negotiate payment terms, and successfully process contractual adjustments.
*Advanced proficiency in analytical tools and software, particularly Excel/spreadsheets, for detailed data analysis and reporting.
*Deep knowledge of collection techniques, laws, and regulations, including AB1455, Knox-Keene Act, Health & Safety Codes, and other relevant statutes
*Extensive familiarity with medical terminology, CPT codes, HCPCS codes, and diverse healthcare networks such as IPAs, HMOs, PPOs, PCPs, and contract affiliations
*Exceptional verbal and written communication skills, adept at effectively communicating with diverse stakeholders and presenting complex information in a clear and concise manner.
*Advanced proficiency in the Microsoft Office suite, specifically Excel and Word.
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