Payment Compliance & Contract Management Collector
Community Health Systems
**Job Summary**
The Payment Compliance & Contract Management (PCCM) Collector is responsible for the timely and efficient resolution of underpaid and overpaid accounts. This role involves managing account follow-up, analyzing trends, collaborating with internal departments, and ensuring accurate reconciliation of account balances. The PCCM Collector assists in optimizing revenue cycle processes and maintaining compliance with contractual agreements.
**Essential Functions**
+ Manages account follow-up for underpaid and overpaid claims, escalating unresolved issues internally as needed to achieve resolution.
+ Reconciles account balances and adjustments to ensure accurate financial status and compliance with contractual terms.
+ Resolves underpayments by engaging in daily communication with payers and negotiating payment discrepancies.
+ Identifies and analyzes trends in underpayments, overpayments, denials, and revenue opportunities to recommend process improvements.
+ Evaluates and interprets contract reimbursement details, providing feedback and insights to the department to enhance revenue cycle performance.
+ Collaborates with financial and clinical departments to address account discrepancies and ensure effective revenue management.
+ Reviews contract validation, updates, and provides interpretation to support accurate claim processing and collections.
+ Ensures thorough and accurate validation of account analysis before distribution, maintaining compliance with policies and procedures.
+ Performs other duties as assigned.
+ Complies with all policies and standards.
**Qualifications**
+ H.S. Diploma or GED required
+ Associate Degree or higher preferred
+ 1-2 years of experience in healthcare collections, revenue cycle, or contract management required
+ 1-2 years Familiarity with payer contracts and healthcare reimbursement methodologies preferred
**Knowledge, Skills and Abilities**
+ Strong analytical and problem-solving skills.
+ Proficient in understanding and interpreting payer contracts and reimbursement terms.
+ Effective communication and negotiation skills.
+ Ability to work independently and manage multiple priorities in a fast-paced environment.
+ Proficiency in healthcare billing software, Google Suite, and Microsoft Office Suite, especially Excel.
+ Attention to detail and high degree of accuracy in reconciliation and analysis.
Equal Employment Opportunity
This organization does not discriminate in any way to deprive any person of employment opportunities or otherwise adversely affect the status of any employee because of race, color, religion, sex, sexual orientation, genetic information, gender identity, national origin, age, disability, citizenship, veteran status, or military or uniformed services, in accordance with all applicable governmental laws and regulations. In addition, the facility complies with all applicable federal, state and local laws governing nondiscrimination in employment. This applies to all terms and conditions of employment including, but not limited to: hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. If you are an applicant with a mental or physical disability who needs a reasonable accommodation for any part of the application or hiring process, contact the director of Human Resources at the facility to which you are seeking employment; Simply go to http://www.chs.net/serving-communities/locations/ to obtain the main telephone number of the facility and ask for Human Resources.
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