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Position: Insurance Collection Rep.
Job Description:
Review CMS and Insurance bulletin newsletters of coding updates, issues, trends and changes applicable to provided services, providing information for financial clearance and billing purposes
Work and manage Insurance claims through Revenue Cycle and Denial Management to a timeline that is determined by commercial, managed care, and governmental insurance providers
Review Insurance claims for effective payment and timely billing turnaround for claim adjudication
Provide timely notation of actions and remediation practices taken on patient accounts.
Electronic claims submission and paper claim submission according to insurance file order for payment and collection activities across all payor types
Re-bill claims with additional ICD-10 codes from Medical report and records when needed
Communicate between departments to facilitate uninterrupted cash flow from payors and patients for balances due and pre-payments for services rendered
Follow CMS updates and adhere to billing guidelines dictated by Medicare CMS guidelines and carriers that adhere to uniform guidelines for payments and reimbursements
Process Insurance and patient refunds, providing payments solutions and recouping patient out of pocket balances across all account types
Respond to patient account inquires and provide billing statements, payment receipts, itemized statement and billing records as requested
Work Insurance correspondence, remittance advice, submit appeals and make adjustments to claims in efforts to receive payments for account receivables
Engage Patient involvement for continued claim issues with Insurance Carriers as needed for Coordination of Benefits and claim remediation purposes(Except Medicare and Medicaid Insurance.)
Notify Management of any Insurance trends identified
Qualifications:
High School Diploma, Certificate of Attendance, Certificate of Completion, GED or equivalent training or experience required.
Minimum 2 Years.
Experience calling patients who have outstanding balances and work out a payment plan, Insurance collection experience/work with insurance carriers, knowledge of billing codes, knowledge of insurance claims process (beginning to end), worker's comp experience is a plus.
Must operate a 10 key calculator, excellent communication skills, both written and verbal, with people of various backgrounds, detailed oriented, problem solver, good math skills.
Microsoft experience preferred.
Proficient in managed care terminology and reimbursement.
Please reference Job number: 175042