Day to Day:
- Provides Liaison between the providers of health care services, the patient, or other responsible persons, and revenue sources, to ensure the correctness of charges, a current record of all transactions, and account resolution
- Maintains active communications with insurance carriers and third-party carriers until account is paid.
- Negotiates payment of current and past due accounts by direct telephone and written correspondence.
- Updates patient account information.
- Monitors and identifies payer denial trends and problem accounts; communicates patterns to supervisor.
- Runs a monthly aging report based on DOS and current A/R to identify accounts that require follow up.
- Manage all assigned worklist daily for assigned insurances.
- Utilize collection techniques to resolve accounts according to company's policies and procedures.
- Report any coding related denial to the Coding Specialist.
- Performs other duties including but limited to faxing information as required, generating retroactive authorization requests, and verifying medical eligibility.
- Conducts necessary research to ensure proper reimbursement of claims.
Required Skills & Experience
- High School or GED
- Minimum 1+ years of medical insurance collections experience with commercial payors
o Commercial payors -- Aetna, Cigna, United Healthcare, Medicaid, the "blues" (BCBS, Anthem, etc.)
- Knowledge of medical terminology utilized in medical collections and billing (CPT, ICD-10, HCPCS)
- Experience with insurance claims and insurance denials
- Experience in payor portals and EHR systems (Availity, CignaforHCP, United Health Care)
Nice to Have Skills & Experience
- Experience in a gastro specialty
- Experience with eClinicalWorks