Medical Collector Specialist

13 hours ago

New Orleans, Louisiana, United States LCMC Health Full time
Job Summary

We are seeking a highly skilled Medical Collector to join our team at LCMC Health. As a Medical Collector, you will play a critical role in ensuring the accurate and timely resolution of patient accounts, denials, and appeals.

Key Responsibilities
  • Maintain responsibility for accurate and timely completion of daily follow-up or denial account assignment
  • Identify and analyze underpayments to identify reasons for discrepancies and process denials and appeals as needed
  • Review posted payments and adjustments to ensure accuracy and analyze EOBs to ensure proper reimbursement
  • Conduct relevant research to complete appeals process, including assessing, complete and accurate documentation, tracking, responding to, and/or resolving appeals with third-party payers in a timely manner
  • Communicate with payers on outstanding claims, resolve payment variances, and achieve timely reimbursement
  • Accurately document all activity on the patient account
  • Collaborate with internal departments and external organizations to ensure correct reimbursement and resolve appeals
  • Monitor underpaid and denied claims for trends and identify root causes, reporting findings to supervisor
  • Demonstrate initiative and resourcefulness by making recommendations and communicating trends and issues to management
  • Observe best practice processes in follow-up and customer service activities
  • Participate in staff training that aligns with recognized improvement opportunities and increase understanding of Medicare/Medicaid requirements as well as general follow-up processes
  • Act in accordance with LCMC's mission and values, serving as a role model for ethical behavior
  • Adhere to federal and state regulations related to the protection of patient information, including HIPAA and facility-specific guidelines
Requirements
  • Minimum two years of experience in a healthcare environment, particularly in healthcare billing, collections, payment processing, or denial management
  • High school diploma or GED
  • Working knowledge of system reports and ability to analyze system information to determine the impact of possible changes
  • Demonstrated knowledge of hospital and professional billing processes and reimbursement, third-party contracting, insurance protocols, delay tactics, systems, and workflows, ERISA guidelines for denials and appeals, and regulations related to denials and appeals
  • Ability to take initiative by identifying problems, conceptualizing resolutions, and implementing change
  • Possesses efficient time-management skills and proven ability to multitask under tight deadlines
  • Demonstrates excellent customer service skills, effective writing and communication skills, and a strong comfort level with computer systems
About LCMC Health

LCMC Health is a community-driven healthcare organization dedicated to delivering exceptional care to every person and parish in Louisiana and beyond. We celebrate authenticity, originality, equity, inclusion, and a little 'come on in' attitude, making us a unique and rewarding place to work.

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