Medical Insurance Collections Associate

Atlantic Vision Partners•Richmond, VA

20d•Onsite

About The Position

This position is on-site in the Willow Lawn area of Richmond As a Medical Insurance Collections Associate, you are responsible for filing insurance claims, managing patient accounts, and answering account status inquiries on optometry and ophthalmology patients. They collect and enter claim information, follow up on unpaid and rejected claims in a timely manner, and may assist with posting insurance and patient payments as needed. Collectors are also held accountable for documenting all customer interactions in the appropriate computer system. Representative reports directly to Revenue Cycle Manager of Collections.

Requirements

High School Diploma or equivalent required.
Computer skills that include a combination of experience in a Windows Operating System, e-mail, and data entry experience.
Three to five years in insurance billing required.
Excellent judgment, dependability, and conscientiousness.
Demonstrated high ethical standards and integrity.
Demonstrated attention to detail.
Demonstrated accuracy and thoroughness; monitors own work to ensure quality.
Customer and patient service orientation: prompt response to patient needs and ability to manage difficult or emotional customer situations with tact, empathy and diplomacy.
Ability to work cooperatively in group situations; offers assistance and support to coworkers, actively resolves conflicts, inspires trust of others, and treats patients and coworkers with respect.
Patient centered care focused, and a team player.
Handles multiple tasks effectively and efficiently and exhibits commitment to effective problem-solving techniques when issues arise.
Continuously acts to maintain a safe, clean, healthy, and fun work environment consistent with AVP’s Mission and Vison.
Arrives on time, ready to work, and demonstrates minimal absenteeism.
Demonstrates effective problem-solving skills
Knowledgeable of Medicare and Medicaid billing and reimbursement concepts and principles.
Willingness to submit to a background check
Exerting up to twenty-five pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects.
Repetitive motion. Substantial movements (motions) of the wrists, hands, and/or fingers.
Must have close visual acuity to perform an activity including viewing a computer terminal, extensive reading, interpretation, etc.
Must be able to be stationary for prolonged periods of time.
Executes tasks independently.
Learns and memorizes tasks.
Maintains concentration/focus on tasks.
Performs task in a demanding environment requiring multi-task and prioritize work.
Must be comfortable working and interacting with large groups of people daily.
Compliance training and testing is required annually and as needed.

Nice To Haves

Prior experience with medical billing software is preferred but not required.

Responsibilities

Enter information necessary for insurance claims such as patient insurance ID, diagnosis and treatment codes and modifiers and provider information. Insures that claim information is concise, complete, and accurate.
Submits insurance claims to clearinghouses or individual insurance companies electronically or via paper CMS-1500 form.
Answers patient questions on patient responsible balances, copays, deductibles, write-offs, etc. Resolves patient complaints or explains why certain services are not covered while demonstrating positive customer relationship skills with all telephone encounters.
Follows up with insurance companies on unpaid or rejected claims. Resolves issues and re-submits claims.
Prepares appeal letters to insurance carriers when not in agreement with claim denial. Collects necessary information to accompany appeal.
Follows up on past due patient balances and provides necessary information to collection agencies for delinquent accounts.
May perform “soft” collections for patient past due accounts. This may include contacting and notifying patients via phone or mail.
Prepares and submits secondary claims upon processing by primary insurer.
Posts insurance and patient payments using medical claim billing software as needed.
Understands managed care authorizations and limits to coverage such as number of visits.
Verifies patient benefits eligibility and coverage.
Meet outlined AVP benchmarks and/or quality indicators as monitored through audits or recordings.
Meets the expectations of our internal and external customers in providing excellent service.
Supports organizational changes. Demonstrates flexibility in providing coverage and/or availability for the insurance department via scheduling adjustments for unexpected absences, events, or work volume variances.
Processes Patient and Insurance Carrier refunds.
Other duties and special projects that are assigned by management.
Follows HIPAA guidelines in handling patient information.