Medical Insurance Collector

Claims And Patient Accounts Specialist

Responsible for obtaining accurate, timely, and detailed information concerning claims and patient accounts.

Essential Functions:

• Call and status outstanding claims with third party payers.
• Review claims issues and make corrections as needed and rebill.
• Utilize claims clearing house to review and correct claims. Resubmit electronically when available.
• Review explanation of benefits to ascertain that claim processed and paid correctly.
• Complete adjustment forms if any adjustments need to be made to an account and attach all supporting documentation.
• Manage daily productivity via patient accounting system and productivity reports. Needs to maintain an average of 30-40 accounts worked per day minimum.
• Prorate patient accounts and monitor that balance due is in the correct financial class.
• Report an overview of the week to the BOD and participate in AR meetings.
• Gather and interpret data from system and understands appropriate course of action to take and initiates time-sensitive and strategic steps resulting in payment.
• Assist financial counselors as needed.
• Alert Financial Counselors and Business Office Director of all benefit eligibility matters that suggest or challenge reimbursement.

Other Functions:

• Perform other functions and tasks as assigned.

Education/Experience/Skill Requirements:

• High school diploma or equivalent required.
• Three or more years' prior admissions and or collections experience in a hospital setting required.
• Psychiatric experience preferred.

Licenses/Designations/Certifications:

• Not Applicable

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