Medical Billing Collector II

Description

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.

Qualifications

• Minimum Education: High School Diploma/G.E.D.
• Minimum 3 Years of experience with insurance collections and follow up.
• Knowledge of both In Network and Out of Network Facility and Physician Claims.
• Knowledge of HIPAA, healthcare regulations and compliance
• Positive attitude, Team player and ability to work independently.
• Must have understanding of Revenue Cycle, Claims Processing and Denial Resolution.
• Prior experience working with commercial payers such as UHC, Cigna, Aetna, BCBS, Marketplace plans and Humana.
• Experience in preparing and submitting claims, facility, physician and specialist.
• Experience in reading, analyzing and interpreting EOB’s from various insurance providers is a must.
• Familiarity with identifying claims in need of appealing, and the appeals process
• Ability to have clearly communicate claim follow up and appeals status with insurance company representatives.
• Demonstrates excellent problem-solving skills and negotiating skills.
• Proven experience in a production-based environment with concentration on meeting production standards.
• Knowledge of EPower and Centricity 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:

• Performs various collection actions including correcting & resubmitting claims to insurance, filling appeals, and A/R reports.
• Understand and stay informed of changes in procedures, billing guidelines, and laws for specific insurance carriers or payers.
• Research, appeal, and resolve unpaid insurance claims.
• Initiating collection follow-up on all unpaid or denied claims with the appropriate insurance carrier.
• 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.
• Work assigned claim volume timely and efficiently within corporate timeframes.
• Maintains multiple spreadsheets for different project tracking.
• Experience with NSA/IDR & is preferred
• High call Volume in both outbound and inbound calls for claim status

Working Conditions:

• 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.

Salary : $21