Precollect Specialist

Pinnacle Healthcare Consulting LLC

10h

About The Position

The purpose of this position is to support PHRS’s mission, vision, core values and customer service philosophy. Responsible for reviewing all patient balances to ensure that all insurance has been filed, coverage detection for other insurance, and account review prior to sending to the collection agency CUSTOMER SERVICE: Accountable for outstanding customer service to all external and internal customers. Develops and maintains effective relationships through effective and timely communication. Takes initiative and action to respond, resolve and follow up regarding patient billing issues with all customers in a timely manner. PRINCIPAL RESPONSIBILITIES AND DUTIES: Responsible for reviewing all patient balances after 90 days to ensure that all insurance has been filed and processed claims Will perform coverage detection to verify that all insurances that the patient is eligible for are filed. Adheres to the medical practice's policies and procedures when answering the phones. Responds to all internal communications regarding patient accounts. Reviews all accounts to make sure all actions have been taken and that the balance is truly patients. Provides accurate information to customers regarding the status of the patients’ accounts. Makes patient payment arrangements on self-pay balances according to policies and procedures. Processes bankruptcy notices and incorrect addresses. Ensures that patient account information is accurate and complete. Documents activity in an accurate and timely manner on the patients’ accounts. Maintains the appropriate proficiency and knowledge with all systems required for task completion. Works with team leads and management to improve processes, increase accuracy, create efficiencies and achieve the overall goals of the department. Ensures compliance with all state and federal billing regulations and reports any suspected compliance issues to the respective supervisor. Other duties as assigned.

Requirements

High school diploma or equivalent is required.
Minimum 3 years of experience medical patient billing
Candidate must understand government and managed care payment methodologies and demonstrate knowledge of terms such as contractual adjustment, allowed amount, coinsurance, denial and denial processes.
Candidates must be familiar with state Medicaid’s and Medicare
Proven ability to maintain professional working relationships with co-workers and customers.
Knowledge of medical terminology.
Knowledge of insurance industry and billing procedures.
Skill in conflict resolution.
Ability to handle multiple priorities at the same time.
Ability to read, understand and follow verbal and written instructions.
Ability to maintain a professional attitude at all times.
Time management skills
Verbal and written communication skills
Skill in operating a computer, copier and fax machine.
Knowledge of Microsoft Office Products

Responsibilities

Responsible for reviewing all patient balances after 90 days to ensure that all insurance has been filed and processed claims
Will perform coverage detection to verify that all insurances that the patient is eligible for are filed.
Adheres to the medical practice's policies and procedures when answering the phones.
Responds to all internal communications regarding patient accounts.
Reviews all accounts to make sure all actions have been taken and that the balance is truly patients.
Provides accurate information to customers regarding the status of the patients’ accounts.
Makes patient payment arrangements on self-pay balances according to policies and procedures.
Processes bankruptcy notices and incorrect addresses. Ensures that patient account information is accurate and complete.
Documents activity in an accurate and timely manner on the patients’ accounts.
Maintains the appropriate proficiency and knowledge with all systems required for task completion.
Works with team leads and management to improve processes, increase accuracy, create efficiencies and achieve the overall goals of the department.
Ensures compliance with all state and federal billing regulations and reports any suspected compliance issues to the respective supervisor.
Other duties as assigned.