MVWC COLLECTOR

The Medical Billing Collector is responsible for the collections, follow-up, and appeals of insurance claims. Essential to this position is the ability to manage all insurance follow-ups for maximum insurance reimbursement. To include outbound and inbound insurance carrier calls, reprocessing claims, drafting appeals, working denials, and resolving unpaid claims.

• Minimum Education: High School Diploma/G.E.D.
• Minimum 3 Years of experience with insurance follow-up and insurance collections.
• Knowledge of both In-network and out-of-network facility and Physician Claims.
• Strong communication skills in both oral and written.
• Positive attitude, Team player, and ability to work independently.
• Experience in reading, analyzing, and interpreting EOBs is required.
• Prior experience working with commercial payers such as UHC, Cigna, Aetna, BCBS, Marketplace plans, and WC/third party is required.
• Prior Experience with the Department of Labor is preferred.
• Proven experience administering appeals in a high-volume claim environment.
• Proven experience in a production-based environment with a concentration on meeting production standards.
• Ability to communicate claim follow and appeals with insurance company representatives.
• Demonstrates excellent problem-solving skills and negotiating skills.
• Knowledge of EPower and Centricity is desired.
• Familiarity with computer and Windows PC applications such as Excel and Word, which includes the ability to learn new computer systems applications.
• Type 45-60 WPM.

JOB RESPONSIBILITIES/DUTIES:

• Work assigned claim volume timely and efficiently within corporate timeframes.
• High call Volume in both outbound and inbound calls for claim status
• Follow all processes and procedures as set by the Training Coordinator and/or department leadership.
• Understanding and staying informed of the changes in procedures, billing guidelines, and laws for specific insurance carriers or payers.
• Initiating collection follow-up on all unpaid or denied claims with the appropriate insurance carrier.
• Research, appeal, and resolve unpaid insurance claims.
• Actively follow up and collect on all electronic claims, including resolution of any billing errors assigned following established procedures.
• Respond to correspondence from insurance carriers.
• Perform other duties as assigned by the department manager.
• Frequent speaking, listening using a headset, use of hands/fingers across keyboard or mouse, handling other objects, long periods working at a computer.
• The service center with moderate noise level due to representatives talking, computers, printers, and floor activity.
• While performing duties of this job, the employee is frequently required to stand, walk, and sit.