Overview
This role involves managing insurance and patient account follow-up to ensure accurate reimbursement and resolution of balances. The position requires expertise in insurance practices, patient billing, and financial assistance programs within a healthcare setting.
Responsibilities
- Understand and reconcile insurance practices for contracted and non-contracted accounts.
- Manage reimbursement and resolution of patient or insurance (hospital or physician) account balances.
- Conduct insurance account follow-up for hospital or physician accounts.
- Perform self-pay account follow-up focusing on collecting patient responsibility balances using assistance programs and tools.
- Handle inbound call center activities related to patient financial responsibilities.
- Administer financial assistance programs such as Financial Assistance, Co-pay Assistance, Free Drug, and Drug Replacement programs.
Requirements
- Education: High school diploma or equivalent, or passed proficiency exam.
- Experience: Minimum of 3 years in accounts receivable within a hospital or physician healthcare setting, including insurance and self-pay collections/billing and insurance verification.
- Demonstrated analytical skills with experience in account reconciliation and balancing.
- Solid knowledge of medical terminology, ICD9 codes, CPT/HCPC codes.
- Familiarity with Medicare Bad Debt laws, Fair Debt Collection Laws, and bankruptcy regulations.
- Understanding of insurance contracts, reimbursement methodologies, and ability to interpret Explanation of Benefits (EOBs).
- Knowledge of collection agency processes, probate court requirements.
- Advanced written and verbal communication skills.
- Proficient with technology and spreadsheet management; ability to analyze trends.
- Excellent organizational skills with the ability to manage multiple priorities.
- Outstanding customer service skills.
- Willingness to travel as needed.
Compensation & Benefits
- Pay is based on work experience, qualifications, and work location.
Equal Opportunity
- The employer is an equal opportunity employer.