Job Description
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
Must Haves:
- 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
Benefit packages for this role will start on the 31st day of employment and include medical, dental, and vision insurance, as well as HSA, FSA, and DCFSA account options, and 401k retirement account access with employer matching. Employees in this role are also entitled to paid sick leave and/or other paid time off as provided by applicable law.