Collections Follow-Up Representative - Float

Job Summary:
The Collection Follow Up - Float performs various activities to follow up on overdue patient accounts to collect from third party payers and patients to increase cash flow and reimbursement for the hospital. The incumbent is assigned a specialty area but is regularly required to float into other specialty collections areas to assist with backlog, increased volume of accounts or cover for temporary staff vacancies.

Education:
Required:
High School graduate or GED. De-escalation training, if applicable.

Preferred:

Experience:
Required:
One to three years industry or other administrative experience preferable in a hospital setting. Insurance knowledge required. Must demonstrate effective communication skills to effectively resolve collection of patient accounts quickly and accurately. Detail oriented, courteous and professional mannerism. Experience should demonstrate thorough understanding of various government and other third party payer regulations.

Preferred:

Position Requirement(s): License/Certification/Registration
Required:
None

Preferred:
Collections Patient Account Representative Certification (CPAR)

Department Position Summary:
The Collection Follow Up - Float incumbent is responsible to resolve assigned accounts within one or more specialty areas. This consists of determining if accounts have been received by insurance companies, if the accounts are paid according to the contract or correct DRG; if adjustment (contractual) are correct or if adjustments were taken. Determines if accounts need rebilling or if an adjustment is needed. Also determine if a refund is due to the insurance carrier or patient. The collector is responsible to determine if secondary insurance is billed and move the money to the appropriate insurance bucket. The collector is responsible to determine if the claim is denied whether or not an appeal is appropriate or if a write off is warranted. The collector is responsible to bring all processing problems to the attention of the manager or his/her designee. The main objective of the collector is to assure that all claims assigned are paid according to the contract or obtain payment from the patient. Review patient liability and try to contact patient for payment arrangements or review for charity according to the PFS guideline. In some cases the collector is responsible to gather needed information for retroactive accounts to send in for approval by the MCO (Maintenance Care Organization). Collectors are given a high dollar list of accounts weekly to be follow up on and returned to the coordinator & supervisor within a specific time frame. The collector also has to meet productivity requirements set by the manager. Regularly floats to other collection specialty areas as needed to assist in heavy volume, staff shortages and the like. Performs other duties as assigned.