A/R Pending

SouthCoast Health•Savannah, GA

17h•Onsite

About The Position

Responsible for collecting outstanding pending insurance patient account balances and resolving patient account issues to collect balances according to department policies and procedures. Works with self-pay insurance staff to resolve patient account issues and collect balances. The role responds to inquiries from physicians, patients, and insurance companies; processes correspondence; provides financial counseling and arranges installment payments; and coordinates collections, approvals, and account placement for collection or write-off. It researches and resolves denied and unpaid claims, resubmits claims as needed, processes approved refunds, reviews aged insurance accounts, corrects electronic submission problems, and balances daily charges, receipts, and adjustment write-offs. The position keeps current with insurance-carrier updates and meets monthly goals established by the department head. This position is primarily office-based and involves regular public and patient interaction, occasional workload-related stress, and extended computer use. Patient information must be kept strictly confidential and accessed only as needed to perform job duties. Applicants selected for employment are subject to pre-employment drug screening.

Requirements

High school graduate or equivalent.
At least two years of experience in a doctor's office or medical insurance company; accounts receivable, collections, or claims experience is preferred.
Two years of medical billing experience.
Computer skills.
Knowledge of third-party insurance processing, insurance terminology, insurance coverage and benefits, collection techniques, customer-service concepts and techniques, and automated collection systems.
Computer proficiency, preferably including MS Word, and ability to use the Internet.
Customer-service skills for working with providers, patients, patients’ families, and coworkers.
Professionalism in dealing with personnel at all levels, patients, and patients’ families.
Ability to communicate clearly and concisely in person, in writing, and by telephone.
Ability to concentrate and pay close attention to detail when reviewing patient financial data.
Ability to organize and prioritize tasks effectively.
Ability to read, understand, and follow oral and written instructions.
Ability to perform essential job functions unaided or with reasonable accommodation, as determined case by case.

Nice To Haves

Experience in accounts receivable, collections, or claims work is preferred.
Proficiency with MS Word is preferred.

Responsibilities

Respond promptly to telephone inquiries from physicians, patients, and insurance companies.
Follow Accounts Receivable policies and procedures established by the Director of Accounts Receivable.
Process correspondence according to department policies and procedures.
Provide financial counseling to patients and arrange installment payments in a culturally and linguistically appropriate manner.
Obtain approvals and coordinate collections according to established policies and procedures.
Obtain the signature of the provider with the highest balance on an account to authorize collection placement and write-off.
Place accounts for collection and meet correspondence deadlines.
Monitor insurance-carrier web portals and posted information for changes affecting Accounts Receivable, collections, and department policies and procedures.
Meet with the supervisor and/or providers at least monthly to communicate insurance-carrier updates and denials; advise the supervisor of carrier changes that may affect procedures.
Research and resolve claims denied by insurance companies, re-filing claims as needed to secure payment.
Research and resolve claims on the unpaid claims management report, re-filing through web portals, fax, paper, or electronically, in that order.
Review credit balances monthly and process refunds according to procedures and approval requirements.
Review the Aged Insurance Pending Report and work accounts in all age categories, including over 91 days, 61–90 days, and 31–60 days.
Review Medicare accounts and other electronic submission problems, determine and make corrections, and resubmit claims to carriers for payment.
Run the Final Charge and Receipt Summary at the end of each day and balance charges, receipts, and adjustment write-offs.
Meet monthly goals established by the department head.
Report to work on a regular and consistent basis.
Maintain patient-information confidentiality and access patient records only as necessary to perform job duties.