Collections Specialist - Patient Financial Services HB

CHRISTUS Health•Alamogordo, NM

About The Position

The Collections Specialist performs timely follow-up and collection of third-party patient accounts in accordance with state and federal rules and regulations, as well as hospital policies and procedures. The role reviews payer reports and account payments, pursues unpaid balances, prepares rebilling and appeals, and documents insurance activity in the computer system. The specialist also adapts assigned services to the physical, psychosocial, cultural, age-specific, and developmental needs of the individuals served.

Requirements

High school diploma.

Responsibilities

Review reports from insurance companies and government payers to determine whether accounts can be resubmitted.
Resubmit claims, bill the patient, or write off accounts as appropriate.
File appeals for rejected services within the applicable filing deadlines.
Follow up on unpaid third-party accounts by telephone or tracer within hospital policy time frames and guidelines.
Prepare rebilling as necessary.
Review correspondence from third-party carriers and respond before insurance company deadlines.
Request medical records when necessary.
Review account payments for accuracy.
Contact insurance carriers when payment is less than quoted benefits to resolve responsibility for the balance.
Calculate or recalculate contractual allowances and make corrections as necessary.
Correct managed care discounts, employee discounts, and other discounts as necessary after recalculating them.
Document all insurance activity in the computer system.
Perform assigned responsibilities in a manner that meets the population-specific and developmental needs of department members.
Adapt assessment, treatment, or service methods to accommodate the physical, psychosocial, cultural, age-specific, and other developmental needs of each member served.