Medical Collector - PB

LCMC Health

6d•Onsite

About The Position

The Collector is responsible for Collections and Denial Management ensuring the appropriate action is taken on assigned accounts in a timely manner resulting in positive resolution.

Requirements

Minimum two years Of experience in a healthcare environment, particularly in healthcare billing, collections, payment processing, or denial management is preferred
A high school diploma or GED
Must be able to pass basic computer skills test and system level training
Working knowledge of system reports and the ability to analyze system information to determine the impact of possible changes
Demonstrates knowledge of: Hospital and professional billing processes and reimbursement, Third-party contracting, Insurance protocols, delay tactics, systems, and workflows, ERISA guidelines for denials and appeals, Regulations related to denials and appeals
Ability to take initiative by identifying problems, conceptualizing resolutions, and implementing change
Possesses efficient time-management skills and proven ability to multitask under tight deadlines
Demonstrates excellent customer service skills
Effective writing and communication skills
Strong comfort level with computer systems

Responsibilities

Maintains responsibility for accurate and timely completion of daily follow-up or denial account assignment
Identifies and analyzes underpayments to identify reasons for discrepancies and process denials and appeals as needed
Reviews posted payments and adjustments to ensure accuracy. Analyzes EOBs to ensure proper reimbursement
Conducts relevant research to complete appeals process to include assessing, complete and accurate documentation, tracking, responding to, and / or resolving appeals with third party payers in a timely manner
Communicates with payers on outstanding claims, resolves payment variances and achieves timely reimbursement
Accurately documents all activity on the patient account
Collaborates with internal departments and external organizations to ensure correct reimbursement and resolve appeals
Monitors underpaid and denied claims for trends and to identify root causes and reports findings to supervisor
Demonstrates initiative and resourcefulness by making recommendations and communicating trends and issues to management
Observes best practice processes in follow-up and customer service activities
Participates in staff training that aligns with recognized improvement opportunities and increase understanding of Medicare/Medicaid requirements as well as general follow-up processes
Acts in accordance with LCMC’s mission and values, while serving as a role model for ethical behavior
Adheres to federal and state regulations related to the protection of patient information (e.g., the Health Insurance Portability and Accountability Act (HIPAA) as well as facility-specific guidelines