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 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: $18 - $27 per hour.
Location
Not specified.