Account Resolution Insurance Collector

Jackson County Memorial Hospital Authority•Altus, OK

23h•Onsite

About The Position

Under the direction of the Account Resolution Supervisor and the Director of Patient Financial Services, the Account Resolution Insurance Collector position is responsible for management of accounts so that accounts receivable is minimized. Job duties include but are not limited to ensuring that claims are processed accurately and efficiently so that maximum hospital reimbursement is received from payers; works all denials in a timely manner according to insurance filing guidelines; escalates any account that needs a first level appeal or has had more than 2 denials on the same claim to the Account Specialist; queues claim and provides all documents to the Account Resolution Billers on accounts that needs to be refiled to any payer; works all mail correspondence daily; assisting customers in person or by telephone to resolve issues and questions associated with their account balances; and assisting supervisor in developing, establishing and implementing operational policies and procedures. Demonstrates Competency in the Following General Areas: Commits to one hundred percent (100%) patient and customer satisfaction by always exhibiting a courteous and helpful manner during interactions with others, including patients, families, visitors, physicians and co-workers. Maintains a general, overall working knowledge of the department’s mission thereby having the ability to provide basic service and support to others, including patients, families, visitors, physicians and co-workers. Recognizes when others are in need of assistance and consistently offers to help when own workload permits. Fully knowledgeable of the comprehensive revenue cycle policies and procedural flow, and able to apply this knowledge to all situations. Demonstrates Competency in the Following Primary Duties: Monitors accounts via system reminders and various reports to ensure that accounts are processed and followed-up in an accurate and timely manner so that maximum hospital reimbursement is received from payers. Works with both internal and external sources through written and oral communication to resolve any issues associated with reimbursement delays and unprocessed claims. Documents all communication and activities on account appropriately to ensure that account history is maintained. Responds to patient questions, inquiries and complaints as needed and documents information on account to ensure that account history is maintained. Secures and witnesses all required signatures according to internal policy and regulation as applicable including Release of Information, Financial Assistance Application, Financial Agreement and other attestations as applicable; appropriately documents all activities to account to ensure that account history is maintained. Ensures that all account balances are paid within the guidelines set forth in the JCMH collection policy; appropriately documents all activities on account to ensure that account history is maintained; communicates with both internal and external parties to ensure that they have been notified of payments, changes or issues regarding accounts. Maintains knowledge of assigned insurance requirements to ensure Jackson County Memorial Hospital does not take unnecessary losses or cause the patient to pay unnecessary penalties; reviews online and paper-based insurance and legal resources to ensure that receipts, adjustments and refunds are applied correctly; interacts with external and internal resources using oral and written correspondence to resolve problems. Maintains overall working knowledge of the Meditech B/AR and LSS module and Change Healthcare application to ensure Account Resolution area processes are completed in the most efficient manner. Creates, prepares and implements electronic procedure manual to ensure that the most efficient and productive methods are being used. Provides backup support and training to Account Resolution Biller position and other Revenue Cycle departments regarding the Account Resolution processes ensuring that daily tasks are performed accurately and efficiently. Prepares Account Resolution area reports on a daily, weekly, monthly or “as needed” basis to ensure that the Account Resolution Supervisor, Director of Patient Financial Services and hospital management are well informed. Keeps Account Resolution Supervisor and Director of Patient Financial Services informed of work activities, needs and problems. Performs job specific duties and all other duties as assigned in a timely and accurate manner.

Requirements

Ability to organize work, direct and set priorities, and effectively accomplish required duties with minimal or no supervision.
Previously worked as an Account Resolution Biller position within the organization.
High school diploma or equivalent required.
Experience in claims and remittance processing required.
Must be able to pass pre-employment testing including clerical ability and typing test.
Must be able to meet the public in a direct and professional manner.
Previous work history that demonstrates steady attendance and punctuality is required.
Must be able to read & communicate effectively in English.
Must be able to communicate firmly what is required of patients in regards to their financial status.
Must be able to communicate (orally and in writing) effectively with patients, doctors and other departments in the institution.
Near visual & hearing acuity required to perform essential duties of position.

Nice To Haves

Advanced degree or active pursuit of advanced degree preferred.
One to two years previous acceptable experience in a Patient Financial Services, Accounts Receivable, Health Information Management or Business office setting preferred.
Intermediate level knowledge of Microsoft Excel, Microsoft Word and/or Microsoft Access preferred.

Responsibilities

Management of accounts to minimize accounts receivable.
Ensuring claims are processed accurately and efficiently for maximum hospital reimbursement.
Working all denials in a timely manner according to insurance filing guidelines.
Escalating accounts needing a first-level appeal or with more than 2 denials to the Account Specialist.
Queuing claims and providing documents to Account Resolution Billers for refiling.
Working all mail correspondence daily.
Assisting customers in person or by telephone to resolve account balance issues and questions.
Assisting supervisor in developing, establishing, and implementing operational policies and procedures.
Monitoring accounts via system reminders and reports for accurate and timely processing and follow-up.
Resolving reimbursement delays and unprocessed claims through written and oral communication with internal and external sources.
Documenting all communication and activities on accounts.
Responding to patient questions, inquiries, and complaints.
Securing and witnessing required signatures according to policy and regulation.
Ensuring account balances are paid within collection policy guidelines.
Communicating with internal and external parties regarding payments, changes, or issues with accounts.
Maintaining knowledge of assigned insurance requirements.
Reviewing online and paper-based insurance and legal resources for correct application of receipts, adjustments, and refunds.
Maintaining working knowledge of Meditech B/AR and LSS module and Change Healthcare application.
Creating, preparing, and implementing electronic procedure manuals.
Providing backup support and training to Account Resolution Biller position and other Revenue Cycle departments.
Preparing Account Resolution area reports.
Informing Account Resolution Supervisor and Director of Patient Financial Services of work activities, needs, and problems.
Performing job-specific duties and other assigned duties in a timely and accurate manner.