Millennium Surgical Center has an immediate need for a full time Collector / Business Office Float.

Job Summary : Under the direction of the Business Office Manager, is responsible for covering any aspect of the business office necessary.

Many duties includes scheduling, insurance verification, collections, financial counseling, patient calls and chart building.

Successful candidate will possess outstanding multi-tasking abilities, communication and teamwork as well as the ability to keep up in a fast paced working environment.

The successful candidate should be able to demonstrate previous successful / positive customer service encounters or programs.

Duties and Responsibilities :

Verifies insurance prior to patient’s arrival, to include Add On's and Direct Admits

Obtains pre-certification from insurance companies for procedures that require pre-certification.

Requests office notes from referring physician if needed for Authorization.

Calculating and Informing patients of amount due

Follow up on delinquent surgery center claims (working an expected number of claims per day) - majority of claims will have been submitted to various insurance carriers electronically.

Knowledge of how to interpret a managed care contract, Medicare and Medicaid and Workers Compensation claims is a must. Tools will be given to calculate allowable and required to determine appropriateness of reimbursement and appeal claims as necessary.

Extensive contact with insurance carriers of all types, as well as communication with patients regarding out of pocket amounts is required.

Identification of accounts that have been either under or over paid, issuing credit balance information either to the insurance carrier or the patient.

Communicating with the Dr. office’s

Ensures all required forms are placed in designated areas of the patient’s chart

Daily preparation of charts for next day’s surgeries within required deadline (NO LESS than 3 days prior to surgery, for all cases scheduled four days or more in advance of surgery date)

Labeling necessary documents and adding physician orders

Out-bound collection calls to patients regarding their medical invoice / bill answering questions and setting up payment / payment plans.

Utilization of various collection strategies and methodologies to contact consumers in order to negotiate payment in full or payment arrangements on debt within federal, state and client collection guidelines and laws.

Other duties as assigned.

Required Skills

• High School Diploma or equivalency.
• 1-2 years of previous medical claims experience required.
• Experience in government payer claim adjudication (Medicare, Medicaid, VA, Tricare) and commercial payers (BCBS, Aetna, Cigna, UHC, etc.)
• Familiar with reading contracts and have the ability to apply those rules to an EOB and determine a follow up / resolution path.
• Familiar with grievance and appeals process.
• Ability to read an EOB
• Must be able to communicate verbally and non-verbally in a professional way.
• Ability to use time wisely in preparing work area to meet high-paced demand.
• Show a genuine desire to work and improve the hospital as a whole.
• Must be able to multi-task.
• Strong medical terminology.
• Must demonstrate excellent phone etiquette and exceptional customer service skills.

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Required Experience

• High School Diploma or equivalency.
• 1-2 years of previous medical claims experience required.
• Experience in government payer claim adjudication (Medicare, Medicaid, VA, Tricare) and commercial payers (BCBS, Aetna, Cigna, UHC, etc.)
• Familiar with reading contracts and have the ability to apply those rules to an EOB and determine a follow up / resolution path.
• Familiar with grievance and appeals process.
• Ability to read an EOB
• Must be able to communicate verbally and non-verbally in a professional way.
• Ability to use time wisely in preparing work area to meet high-paced demand.
• Show a genuine desire to work and improve the hospital as a whole.
• Must be able to multi-task.
• Strong medical terminology.
• Must demonstrate excellent phone etiquette and exceptional customer service skills.

LI-CT1

Last updated : 2024-05-13