What are the responsibilities and job description for the Collections Representative position at KGTiger Corporation?
Job Details
Job Title: Collections Representative
Location: Philadelphia, PA
Work Arrangement: Onsite
Duties:
- Patient A/R Experience in Healthcare (1 Yrs Min)
- Denial Management
- EOBs
- Rejections/ Denial review
- Credit balances
- Payer enrollment
- Open patient A/R follow-up experience
Experience Required:
- Minimum of 1 year; prefer 5-7 years of insurance follow-up, AR collection, denial management for commercial and government payors.
- Anesthesia experience is preferred.
- EPIC experience is necessary.
- Must have insurance follow-up experience, preferably in physician billing and/or anesthesia billing.
Responsibilities:
- Ensure correct and timely reimbursement from third-party payors for services provided by Children s Anesthesiology Associates, Ltd. (CAA).
- Appeal, re-bill, and perform necessary actions to collect revenue due to CAA.
- Involved in other AR-related projects daily.
- Investigate, analyze, identify, and reduce barriers to correct adjudication (e.g., Network Set-Up, Fee Schedules, Denial Management, Contract Compliance).
- Maximize reimbursements through timely follow-up of accounts.
Key Responsibilities:
1. Proven working experience as a Collections/Account Receivable Rep.
2. Solid understanding of insurance follow-up, denials, reimbursements, contracts, and insurance
policies.
3. Investigate Accounts identified as low pays, denials, or otherwise (75% of duties):
- Review accounts in work file/queue and resolve in compliance with CAA s contracts and agreements.
- Contact insurance companies/third parties as needed.
- Comment on actions taken to resolve accounts.
- Analyze and identify barriers to claim submission and processing.
- Ensure timely claim submissions, appeals, and requested information.
- Handle insurance explanations of benefits as required.
- Assist with special projects, audits, and reconciliations.
4. Reconcile credit balances and submit refund requests in accordance with policies (15% of duties).
5. Investigate and submit for approval write-off allowances and adjustments in alignment with CAA s policies (10%).
6. Collaborate professionally with Co-workers and staff in related areas.
7. Meet minimum production and performance targets.
8. Perform daily correspondence.
9. Other duties as assigned.
Skills:
- Minimum 5-7 years of insurance follow-up, AR collection, denial management for commercial
- and government payors.
- Anesthesia experience preferred, EPIC experience necessary.
- Proficient in Microsoft Excel and large data sets.
- Strong analytical, interpersonal, and organizational skills.
- Ability to handle multiple tasks and meet deadlines.
- Excellent phone etiquette; strong customer service skills.
Education:
- High school diploma or equivalent with three years of experience in the medical field, preferably with physician billing/collections.
- Must have insurance follow-up experience.
Compliance Level: 2A, No Covid Vaccination Required
Certifications & Licenses:
- EPIC preferred
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