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Patient Account Collector

Aran Eye Associates
Miami, FL Full Time
POSTED ON 3/12/2025
AVAILABLE BEFORE 4/11/2025
Summary

The Medical Collector is responsible to locate and notify payers of underpayments and work denials by telephone, email and/or fax to ensure promptly and efficient collection. Contact patients by phone and/or mail regarding their accounts and is responsible for ensuring collection of past due balances. Answer debtor account questions and assists in setting up alternative pay plans when necessary. Maintains debtors account records and may settle third party payer issues. Relies on limited experience and judgment to plan and accomplish daily targets and monthly goals. Perform a variety of tasks. Work under general supervision.

Essential Duties And Responsibilities

Administrative/Clerical Duties

  • Responsible to create new ideas and offer suggestions to enhance quality of work performed and decrease future denials by identifying trends with assigned payers.
  • Responsible to audit claims and search for underpayments.
  • Responsible to read and interpret explanation of benefits (EOBs) and elements of HCFA.
  • Responsible to work denials and process appeals and corrected claims as needed.
  • Responsible to collect claims data to be reviewed.
  • Responsible to call payers to resolve underpayments/denials found.
  • Responsible to write appeal letters as needed to payers to resolve underpayments/denials.
  • Responsible to follow up on appeals.
  • Responsible to follow up on work cases after appeals to ensure payment receipt.
  • Maintains an open line of communication with Manager and Upper Manager.
  • Responsible to report any findings to Immediate Manager.
  • Performs all other designated duties as directed by Finance Manager

Minimum Demonstrated Skills

  • Knowledge of medical terminology.
  • Ability to handle and diffuse patient complaints and disagreements.
  • Ability to assess and respond to urgent issues in a competent manner and work calmly and politely in stressful situations.
  • Exceptional communication and interpersonal skills.
  • Personable and empathetic with patient’s needs and concerns.
  • Ability to establish and maintain positive and effective work relationship with coworkers, doctors, patients, insurance companies.
  • Well-organized with attention to detail.
  • Demonstrates computer literacy.
  • Displays consistent professionalism.
  • Takes pride and ownership in success and image of the company.
  • Demonstrates initiative in accomplishing practice goals.
  • Self-Motivated / Assertive / Aggressive/ Courteous
  • Strong interpersonal and negotiation skills.

Other Job Requirements

  • Thorough knowledge of the Health Care and Insurance Industries, as well as Medicare, Medicaid, PPOs, HMOs and commercial insurance guidelines and regulations.
  • Proven ability to effectively collect on denied, unpaid, and underpaid claims
  • Ability to read and interpret explanation of benefits (EOBs) and elements of HCFA
  • Must be able to manage multiple collection projects/ employees.
  • Analytical and problem solving skills necessary to investigate various issues with insurance carriers and their contracts and to respond to questions and resolve problems.
  • Interpersonal skills, professional conduct, and oral and written communication skills to effectively gather information, ask questions, and discuss problems with internal personnel and insurance companies
  • Knowledge of Medical billing Software
  • Extensive knowledge of ICD-9, CPT-4 and/or HCPCS coding systems Knowledge of insurance submittal procedures and medical forms
  • Experience performing account resolution with third party payers
  • Experience working with accounts receivable collections from payers
  • Experience working within payer and clearing house portals
  • Ability to effectively identify and communicate payer trends.
  • Ability to Manage time efficiently to complete all assigned accounts and work all assigned accounts

Qualifications/Background Requirements

  • Minimum of 4 years of experience in a Physician or Hospital billing and collections (Ophthalmology preferred)
  • Ability to handle multiple tasks simultaneously
  • Bilingual: English and Spanish
  • Enthusiastic team player
  • Outstanding patient service skills
  • Strong work ethic

Education

High School Diploma or GED required.

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