Include the following. Other duties may be assigned.
Responsible for all aspects of follow up and collections, including making telephone calls, accessing payer websites. Identify issues or trending and provide suggestions for resolution. Accurately and thoroughly documents the pertinent collection activity performed. Review the account information and necessary system applications to determine the next appropriate work activity. Verify claims adjudication utilizing appropriate resources and applications. Initiate telephone or letter contact to patients to obtain additional information as needed. Perform appropriate billing functions, including manual re-bills as well as electronic submission to payers. Edit claims to meet and satisfy billing compliance guidelines for electronic submission. Manage and maintain desk inventory, complete reports, and resolve high priority and aged inventory.
Participate and attend meetings, training seminars and in-services to develop job knowledge. Participate in the monthly, quarterly and annual performance evaluation process with their Supervisor. Respond timely to emails and telephone messages as appropriate. Communicate issues to management, including payer, system or escalated account issues.
Good written and verbal communication skills
Intermediate technical skills including PC and MS Outlook
Intermediate knowledge of UB-04 and Explanation of Benefits (EOB) interpretation
Intermediate knowledge of CPT and ICD-9 codes
Intermediate knowledge of insurance collections and insurance terminology
Include minimum education, technical training, and/or experience preferred to perform the job.
- High school diploma or equivalent education
- 0-4 years of experience in Medical/Hospital Insurance related collections
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Office/Team Work Environment
Employment practices will not be influenced or affected by an applicant’s or employee’s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.
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