COLLECTIONS REPRESENTATIVE - FT

Overall Responsibility:

Responsible for all appropriate collection activities to obtain full reimbursement and payment from patients and third party payors.

Key tasks and responsibilities (essential functions):

• Maintains and works all facility accounts, meeting all collection activity schedules as established by the Manager.

• Refers difficulties or problems involving billing and collection efforts immediately to the Manager.

• Utilizes collection evaluation tools regularly to meet cash collection goals, following through to completion on all patient and insurance questions and problems. Ensures complete and proper documentation in the system.

• Monitors accuracy, timeliness and completeness of patient accounts, including; demographic, insurance, referral and pre-certification information.

• Maintains complete and accurate files of all insurance information and contracts. Keeps abreast of insurance changes and requirements. Ensures that up to date carrier information is maintained in the computer.

• Audits all EOBs to ensure accuracy of reimbursements and that proper adjustments have been made. Completes all appeal processes as needed.

• Maintains and handles maintenance of system relating to patient accounting.

• Maintains expert knowledge of A/R system and A/R system reports.

• Reviews all Medicare cases to ensure compliance.

• Provides invoice for surgical supplies if needed.

• Helps maintain patient confidentiality standards for both medical and financial information.

• Keeps job related skills current through training programs.

• Participates in all compliance programs.

• Participates in loss prevention by protecting company assets and maintaining a safe environment.

• Performs other duties or functions as assigned by Manager.
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• Licensure and Certification: None required.

Experience/Education: At least one year experience in collecting/patient account management in a healthcare setting preferred. Proven knowledge of correct collection practices, knowledge of Medicare Compliance billing guide, Medicare/Medicaid and Managed Care contracts preferred. Knowledge of global and bundling coding guidelines preferred. High school diploma or equivalent required.

Environmental and physical requirements - Requires prolonged sitting, some bending, stooping and stretching. Requires eye-hand coordination and manual dexterity sufficient to operate a keyboard, photocopier, telephone, calculator and other office equipment. Requires normal range of hearing and eyesight to record, prepare and communicate appropriate reports. Requires communication skills to deal well with employees, patients, families, physicians and vendors. May require lifting of 20-30 pounds maximum, potential for exposure to blood and body fluids (minimal), and exposure to infectious disease.