Overview
This role is responsible for collecting commercial, government, and patient balances by following approved processes, policies, and procedures established by the revenue cycle department.
Responsibilities
- Monitor outstanding account balances to determine the next step in the collection process.
- Follow up on claims and claim denials to ensure maximum reimbursement for services provided.
- Review accounts receivable activities and contact outstanding balances or claims.
- Generate appropriate paperwork, including insurance claim forms (original and re-filed) and collection letters.
- Review insurance payments (Explanation of Benefits – EOBs) to verify reimbursement accuracy.
- Navigate portals to send claims for adjudication.
- Investigate and appeal denied or underpaid claims.
- Respond promptly and courteously to inquiries from patients and payors via telephone or written communication.
- Track and resolve discrepancies.
- Follow up on unpaid insurance claims after denial to obtain settlement.
- Audit insurance and patient accounts to determine if refunds are necessary.
- Provide clear communication and customer service on collection issues to external customers and internal business partners.
- Assist patients in developing payment plans.
- Identify patterns and trends indicating potential issues.
- Adhere to all policies and procedures while supporting a culture of high quality and customer service.
- Submit billing data to insurance providers.
- Participate in continuing educational activities related to assigned duties.
- Perform other duties as necessary or in the best interest of the organization.
Qualifications
- High school diploma or GED required.
- Computer proficiency and experience with Windows-based technologies.
- Ability to handle confidential and sensitive information discreetly.
- Prior work experience in a medical office setting preferred.
- Excellent problem-solving skills and attention to detail.
- Ability to manage multiple tasks independently.
- Positive attitude when handling difficult situations.
- Strong interpersonal, oral, and written communication skills.
- Strong organizational and time management skills.
- Ability to meet deadlines in a timely manner.
- Ability to work collaboratively as part of a team with peers and leadership.
- High level of interpersonal skills, including the ability to respond calmly and make rational decisions in stressful situations.
Compensation & Benefits
- Pay range: $20-25 per hour.
Equal Opportunity Statement
The employer is an equal opportunity organization committed to building a diverse and inclusive workforce. Discrimination based on race, color, religion, sex, sexual orientation, gender (including pregnancy, childbirth, or related medical conditions), gender identity or expression, national origin, marital status, age, disability, veteran status, or other legally protected characteristics is not tolerated. Accommodations for disabilities are available upon request.