JOB SUMMARY:

Coordinates the collection of accounts per department guidelines through contact with insurance carriers, clinicians, and office managers until reimbursement are made.

EDUCATION/EXPERIENCE:

High school diploma or GED equivalent with three years experience with medical time, billing procedures, and insurance reimbursement filing. Experience with Medicaid reimbursement rules and payment procedures is required.

ESSENTIAL FUNCTIONS:

1. Uses current software and knowledge of policies and procedures to close out monthly payments. Posts payments for the month, generate monthly reports and balances monthly payments after posting.

2. Audits and reviews daily reports and claims to ensure account accuracy. Accurately determines insurance, processes billing statements and claims, and investigates incomplete claims ensuring resolution.

3. Completes correspondence from the insurance carrier or patient to ensure prompt reimbursement by identifying issues and resolving them, investigating carrier delay reasons, and assisting with requests for additional information. Researches and resolves patient and provider questions and complaints. Investigates insurance company requests for refunds of overpayment or incorrectly paid claims.

4. Coordinates collection efforts and troubleshoots accounts with the local center by meeting regularly with office managers. Tracks and reports insurance denials and questions and/or problems.

5. Determines accounts ready for Bad Debt placement or other adjustments or discounts by working with local center office managers. Identifies and resolves claims discrepancies and works with the local center to determine priorities.

6. Achieves collection objectives by identifying and evaluating collection options and choosing a course of action. Assembles accounts for calling and uses analytical skills in resolving issues. Tracks account status using account aging reports.

7. Coordinates with the administrative supervisor to ensure a smooth work flow.

8. Provides backup assistance and guidance to the center office staff regarding training updates and questions, as necessary.

SKILLS/QUALIFICATIONS:

Excellent oral and written communication skills. Strong organizational and problem-solving skills. Works independently with minimal supervision. Analytical skills detail oriented.