Overview
This role involves managing patient accounts within the healthcare revenue cycle management sector, focusing on the resolution of patient account balances through insurance claim follow-ups and collections from government and non-government payors.
Responsibilities
- Research and resolve uncollected account balances using patient accounting applications and internet resources.
- Contact third-party payors and patients via phone, email, or online to address account issues.
- Update plan IDs, patient demographics, and insurance information as needed.
- Identify payor issues and trends and resolve recoupment challenges.
- Request additional documentation from patients and medical records upon payor requests.
- Review contracts for billing or coding discrepancies and request necessary re-bills or corrections.
- Open dispute records for accounts requiring further research.
- Maintain current desk inventory without backlog while meeting productivity and quality standards.
- Assist with special projects and communicate findings.
- Monitor and respond to potential payment delays and aging accounts, escalating as appropriate.
- Attend meetings, training seminars, and in-services to develop job knowledge.
- Respond promptly to emails and telephone messages.
- Ensure compliance with State and Federal laws and regulations related to managed care and third-party payors.
Requirements
- High School diploma or equivalent; some college coursework in business administration or accounting preferred.
- 1-4 years of medical claims and/or hospital collections experience.
- Minimum typing speed of 45 words per minute.
- Thorough understanding of the revenue cycle process, including patient access, billing, insurance appeals, and collections.
- Intermediate proficiency with Microsoft Word and Excel.
- Ability to quickly learn hospital systems such as ACE, VI Web, IMaCS, and OnDemand.
- Clear and professional communication skills, both oral and written.
- Strong interpersonal, analytical, and critical thinking skills.
- Knowledge of Commercial, Managed Care, Medicare, and Medicaid collections and contracts.
- Familiarity with insurance terms like HMO, PPO, IPA, Capitation, and understanding of EOB.
- Understanding of hospital billing forms such as UB04 and HCFA 1500.
- Ability to problem solve, prioritize, and complete assigned tasks independently.
Compensation & Benefits
- The pay range and compensation package for this role will be determined based on the candidate’s experience, skills, and other relevant factors.
Equal Opportunity
The employer is an equal opportunity organization committed to diversity and inclusion. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, or national origin.
Location
This is a remote position.