The Medical Billing Collector is responsible for the collections, follow-up, and appeals of insurance claims. Essential to this position is the ability to manage all insurance follow-ups for maximum insurance reimbursement. To include outbound and inbound insurance carrier calls, reprocessing claims, drafting appeals, working denials, and resolving unpaid claims.
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Minimum Education: High School Diploma/G.E.D.
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Minimum 3+ Years of experience with insurance follow-up and insurance collections.
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Knowledge of both In-network and out-of-network facility and Physician Claims.
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Strong communication skills in both oral and written.
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Positive attitude, Team player, and ability to work independently.
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Experience in reading, analyzing, and interpreting EOBs is required.
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Prior experience working with commercial payers such as UHC, Cigna, Aetna, BCBS, Marketplace plans, and WC/third party is required.
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Prior Experience with the Department of Labor is preferred.
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Proven experience administering appeals in a high-volume claim environment.
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Proven experience in a production-based environment with a concentration on meeting production standards.
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Ability to communicate claim follow and appeals with insurance company representatives.
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Demonstrates excellent problem-solving skills and negotiating skills.
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Knowledge of EPower and Centricity is desired.
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Familiarity with computer and Windows PC applications such as Excel and Word, which includes the ability to learn new computer systems applications.
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Type 45-60 WPM.
JOB RESPONSIBILITIES/DUTIES:
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Work assigned claim volume timely and efficiently within corporate timeframes.
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High call Volume in both outbound and inbound calls for claim status
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Follow all processes and procedures as set by the Training Coordinator and/or department leadership.
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Understanding and staying informed of the changes in procedures, billing guidelines, and laws for specific insurance carriers or payers.
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Initiating collection follow-up on all unpaid or denied claims with the appropriate insurance carrier.
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Research, appeal, and resolve unpaid insurance claims.
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Actively follow up and collect on all electronic claims, including resolution of any billing errors assigned following established procedures.
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Respond to correspondence from insurance carriers.
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Perform other duties as assigned by the department manager.
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Frequent speaking, listening using a headset, use of hands/fingers across keyboard or mouse, handling other objects, long periods working at a computer.
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The service center with moderate noise level due to representatives talking, computers, printers, and floor activity.
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While performing duties of this job, the employee is frequently required to stand, walk, and sit.