Collection Follow Up-PAT

Erlanger Health System • Chattanooga, TN

89d

About The Position

The Patient Account Technician/Collections and follow-up is responsible to work accounts assigned. This consists of determining if accounts have been received by insurance companies, if the accounts are paid according to the contract or correct DRG; if adjustment (contractual) are correct or if adjustments were taken. Determining if accounts need rebilling or if an adjustment is needed. Also determine if a refund is due to the insurance carrier or patient. The collector is responsible to determine if secondary insurance is billed and move the money to the appropriate insurance bucket. The collector is responsible to determine if the claim is denied whether or not an appeal is appropriate or if a write off is warranted. The collector is responsible to bring all processing problems to the attention of the Payer Coordinator, Supervisors or Managers. The main objective of the collector is to assure that all claims assigned are paid according to the contract or obtain payment from the patient. Review patient liability and try to contact patient for payment arrangements or review for charity according to the PFS guideline. In some cases, the collector is responsible to gather needed information for retroactive accounts to send in for approval by the MCO (Maintenance Care Organization). Collectors are given a high dollar list of accounts weekly to be follow up on and returned to the coordinator & supervisor within a specific time frame. The collector also has to meet productivity requirements set by Supervisor or Managers. Performs other duties as assigned.

Requirements

• High School graduate or GED.
• Must be able to communicate effectively to resolve collection of patient accounts quickly and accurately.
• Detail oriented, courteous and professional mannerism.

Nice To Haves

• One to three years industry or other administrative experience preferable in a hospital setting.
• Collections Patient Account Representative Certification (CPAR).

Responsibilities

• Work accounts assigned to determine if received by insurance companies.
• Verify if accounts are paid according to the contract or correct DRG.
• Check if adjustments (contractual) are correct or if adjustments were taken.
• Determine if accounts need rebilling or adjustments.
• Assess if a refund is due to the insurance carrier or patient.
• Bill secondary insurance and allocate funds to the appropriate insurance bucket.
• Evaluate denied claims for potential appeals or write-offs.
• Report processing problems to the Payer Coordinator, Supervisors, or Managers.
• Ensure all claims assigned are paid according to the contract or obtain payment from the patient.
• Review patient liability and contact patients for payment arrangements or charity review.
• Gather information for retroactive accounts for MCO approval.
• Follow up on high dollar accounts weekly and return to the coordinator & supervisor.
• Meet productivity requirements set by Supervisor or Managers.
• Perform other duties as assigned.

What This Job Offers

• Education Level: High school or GED
• Number of Employees: 1,001-5,000 employees