Managed Care Biller / Collector - Mon - Fri - Hybrid

Northeast Georgia Health System

20h•Hybrid

About The Position

Bills third party claims to managed care payers. Performs insurance collection duties on delinquent insurance balances. Reviews accounts for previous collection activity and appropriately proceeds with collection activities. Manages communications with payers and employers as appropriate. Maintains clear and concise documentation of collection activities.

Requirements

High School Diploma or GED.
One year minimum collection or business office experience.
Knowledge of collection procedures and regulations
Personal Computer proficiency
Excellent verbal and written communication skills
Teamwork skills necessary
Thorough knowledge of Third Party Billing guidelines and UB04 data
Ability to work in various systems simultaneously

Nice To Haves

Previous hospital and or insurance collection experience.

Responsibilities

Ability to thoroughly review and understand all documentation in the NGMC Patient Accounting core system.
Proficiency is required in the claims processing software.
Thoroughly reviewing claims and making necessary corrections prior to submission to the payor.
Maintains the number and dollar amount of claims held in the billing scrubber to the expected minimum levels, alerting supervisor promptly if unable to resolve an error within 24 hours.
Identify, retrieve, print and mail hard-copy claims for non-electronic payors, ie: workers compensation and auto insurance.
Resolve claim rejections daily, and work with supervisor to "root cause" and report to the appropriate departments on a regular basis.
Contacts insurance companies via telephone and websites to expedite claim processing and payment.
Completes Medical Records requests as needed via the HealthPort "e-request" system.
Documents the patient account thoroughly and accurately in order to leave sufficient information for any other party reviewing the account for future collection efforts, which may include presentation in court.
Assists other Revenue Cycle departments in dealing with insurance collection matters.
Documents collection efforts in the "Receivables Workstation" system to accurately identify insurance denial/delay root causes.
Contacts patients and/or responsible parties to inform them of documents or information needed for insurance to process claim for payment.
Actively participates in the Commercial/Managed Care team, including visual management and problem solving activities.
Submits secondary claims electronically and/or hard-copy with the necessary primary payer information.