Collections Representative - Remote in CST or EST
About the position
The position involves performing research and processing appeals, corrected claims, and denial reasons in the healthcare industry. The role is essential in ensuring compliance with payer guidelines and departmental procedures, ultimately contributing to improved health outcomes and financial performance for the organization. Employees will work full-time, with flexibility required during business hours, and will receive comprehensive training to support their success in the role.
Responsibilities
Perform research on assigned payer guidelines when processing appeals, corrected claims or denial reasons
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Stay up to date on all payer requirements and changes
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Comply with departmental Business Rules and Standard Operating Procedures
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Focus efforts on decreasing the Accounts Receivable, increasing cash, and/or reducing bad debt
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Interpret explanation of benefits for appropriate follow up action
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Utilize automation tools to verify eligibility, claim status and/or to obtain better billing information
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Create work list through database and manipulate data to analyze for trends and resolve claims for adjudication
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Review and research denied claims by navigating multiple computer systems and platforms, in order to accurately capture data/information for processing
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Communicate and collaborate with members or providers to evaluate claims errors/issues, using clear, simple language to ensure understanding
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Work on various other projects as assigned/needed
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Meet the performance goals established for the position in the areas of efficiency, accuracy, quality, patient, and client satisfaction and attendance
Requirements
High School Diploma / GED
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Must be 18 years of age OR older
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2+ years of experience in medical account receivable and/or medical billing/collections in the Healthcare industry
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Computer & phone skills, including working knowledge of Microsoft Windows and navigation, mouse, and keyboarding skills
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Intermediate level of experience with Microsoft Word (creating and editing documents)
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Intermediate level of experience with Microsoft Excel (data entry, sorting/filtering)
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Ability to work any full time (40 hours/week) shift between the hours of 8:00 AM - 5:00 PM CST from Monday - Friday
Nice-to-haves
Knowledge of full version Adobe (creating and editing documents)
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Medical claims experience
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Medicare OR Medicaid collections experience
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EOB experience
Benefits
Comprehensive benefits package
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Incentive and recognition programs
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Equity stock purchase
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401k contribution
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