AR Insurance Collector
e CancerCare
Job Purpose: The Insurance collector generates revenue by monitoring and pursing payment on all unpaid and delinquent accounts in a timely manner; serving as a liaison between provider, payors, and patients with regards to payment and collections; and maintaining daily and monthly productivity goals to maximize cash flow. The Insurance Collector will be engaged in all efforts of the collections, claim denials, patient accounts, and various administrative duties. You must be able to maintain a high level of professionalism and be able to interact, communicate, and building relationships with all internal and external customers. Essential Functions: Verification of insurance benefits if missed by front office Able to research denied CPT code/dx codes with comparison to the LCD/NCD requirements. Effectively identifies trends and inhibit timely payment. Monitors accounts receivable follow-up work queues and reports. Work an average of 40 to 80 denials per day based on supervisor requirements and accounts assigned. Works closely with insurance carriers for reimbursement requirements to ensure timely payment Reviews outstanding AR accounts and contacts insurance for reimbursement explanation. Provides clear and accurate documentation of all contacts with internal or external customers. Quickly becomes familiar with duties and performs them independently, accurately, efficiently, promptly, and Recognizing their importance and relationship to patient care. Consults with appeals department for disputed medical necessity denied claims. Works and Understands electronic claim interchange and the life cycle of the claims process. Ability to read and interpret electronic remittance advice. Manages relationships with third party payers, hospital departments, and patients to obtain information required for account receivable resolution. Takes Incoming calls from payors, patients, and all clinical personnel. Regular attendance and punctuality Contributes to team effort by accomplishing related results as needed. Utilizes internal and payer technology and resources to support account resolution activities. Ensures that all processing and reporting deadlines are consistently achieved. Adhere to all standard operating procedures. Performs any other functions as required by management. Qualifications and Education Requirements Minimum 2 years’ experience in Revenue Cycle Insurance Collection Processes. Understanding of Medicare, Medicaid, and third party billing/coding guidelines. Experience with multiple billing and EMR Systems. Experience with computerized billing software, EMR, and interpreting EOBs. Working knowledge of ICD-9/ICD-10, CPT, HCPCS, and CPT coding Preferred Skills CPC, CPB, or other coding credentials preferred but not required. Knowledge of medical terminology Familiar with Chemotherapy and Radiation Billing Required Competencies Ability to work in a team environment and be able to multi task. Strong Business and Organizational Competence. Exceptional Customer Service Skills. Strong functional Competence. Interpersonal Skill Competency. Stress Tolerance. Initiative. Adaptability. Accountability. Integrity. Self-Confidence. Time Management Skills with an emphasis on multi-tasking. Ability to maintain a professional, polished image. Ability to communicate effectively, both written and verbal. Physical Demands and work environment The physical demands and work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Physical demands: Required job duties are essentially sedentary in nature, consisting of occasional walking, standing, lifting and/or carrying twenty five pounds maximum, seeing, speaking and hearing. Must be able to lift up to 25 pounds. Work environment: Required job duties are normally performed in a climate-controlled office environment.
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