Medical Collector

Medical Collector

Location: Pearland Area

Summary:
Collector will be responsible for managing the clients Account Receivables. This includes collections from patient families, third party payers, government entities, etc. This person must have extensive collections experience, especially with Denials and Appeals.

Functions/ Responsibilities:
1. Department days in A/R average
2. Responsible for collection efforts on accounts receivable as assigned by the AR Director. Responsible for claim progress by using every available avenue, such as online tools, automated systems, and payor representatives. Maintains timely and accurate notes on the patient account to reflect current status of claim payment.
3. Responsible for analysis of Explanation of Benefits for non-covered and/or denied charges. Completes required research for disposition, i.e. claim correction, appeal, or adjustment. Prepares appeal to payor specifications, i.e. correct forms and copy of patient's medical record to support medical necessity denials. Coordinates all activity for claim corrections through PAS system, electronic billing system, payor websites, as appropriate to the payer.

4. Responsible for analysis of Aged Trial Balances for assigned payors. Ensures that every account has been timely and accurately billed, has a current status note, is in the automated work queues, and is moving through the collection cycle.
5. Responsible for incoming phone calls related to assigned payors by providing exceptional customer service and follow up. Possess good interpersonal skills.
6. Identifies and reports any trends with non-covered or denied line items. Informs AR leadership team of trends and/or unusual errors by providing examples and payor guidelines. This process will initiate collaboration with other departments as needed to ensure process improvement including additional employee training, as appropriate to error.
7. Responsible for reviewing/monitoring payor websites, CMS website, Dept of Insurance (specific to region), and all available avenues for any changes/updates that affect the billing and/or patient account process related to assigned payors. Informs AR Director of changes to initiate implementation of system/process updates

#ZR4
IND 004-007