Hospital A/R Collector

Dallas CSO - Hospital (01072) • Dallas, TX

450d

About The Position

The Hospital A/R Collector position is responsible for managing and resolving outstanding accounts receivable related to surgical claims, ensuring maximum reimbursement for the hospital. This role requires a strong understanding of medical collections, insurance billing, and denial processing, and involves direct communication with insurance companies and patients to facilitate payments and appeals.

Requirements

• 3+ years of hospital collections experience preferred.
• Excellent communication skills and interpersonal skills.
• Skilled in time management and prioritization of emergent situations.
• Excellent customer service skills, demonstrating professionalism.
• Ability to read and interpret insurance explanations of benefits and managed care contracts.
• Knowledge or experience working with a variety of health care insurance payers is preferred.
• Intermediate computer proficiency in Microsoft Office including Excel and Outlook.
• DDE, Ability Ease, nThrive, Cerner, Advantx, Vision, HST, Waystar experience preferred.
• High School Diploma or equivalent.

Responsibilities

• Timely follow-up and resolution on all outstanding A/R including unpaid/underpaid/denied claims for all payers including self-pay to obtain maximum reimbursement.
• Manage daily work queue to prioritize high dollar claim balances.
• Perform insurance claim follow-ups for insurance denials and appeals; contact insurance companies to check eligibility and benefits via phone or online.
• Review payers contracts to ensure claims have processed correctly.
• Review & work incoming insurance and patient correspondence including refund requests.
• Prepare and write medical necessity appeals when appropriate or provide the requested medical documentation.
• Review patient balances to ensure accuracy and follow up with patients to obtain payments.
• Review insurance payments and determine accuracy of reimbursement based on contracts, fee schedules or summary plan documents.
• Leverage knowledge of Medicare, state Medicaid, and local coverage determinations (LCD's) for claim resolution.
• Negotiate payment amounts for procedures with Third Party Administrators for out of network providers.
• Recommend an adjustment when applicable or recommend a refund for overpayments to insurance carriers or patients, providing the appropriate documentation.

What This Job Offers

• Job Type: Full-time
• Education Level: High school or GED