Representative - Collections L1

Atlas Healthcare Partners•Phoenix, AZ

4d•Onsite

About The Position

Collections Representative is responsible for follow up on delinquent surgery center claims, working an expected number of claims per day. Majority of claims will have been submitted to various insurance carriers electronically. Knowledge of how to interpret a managed care contract, Medicare and Medicaid and Workers Compensation claims is a must. You will be given tools to calculate allowable and required to determine appropriateness of reimbursement and appeal claims as necessary.

Requirements

High school diploma or GED required.
Requires knowledge of at least one of the following: patient financial services, financial, collecting services, or insurance industry experience processes normally acquired over up to two years of work experience.
Requires the ability to manage multiple tasks simultaneously with minimal supervision and to work independently.
Requires strong interpersonal, oral, and written communication skills to effectively interact with a wide range of audiences.
Strong knowledge in the use of common office software, word processing, spreadsheet, and database software are required.

Nice To Haves

Additional related education and/or experience preferred.

Responsibilities

Contact payors and patients to effectively and accurately collect for services provided by Atlas centers.
Interpret a managed care contracts, Medicare and Medicaid and Workers Compensation to appropriately calculate allowable and determine appropriateness of reimbursement.
Interpret patient eligibility and plan structure to determine patient responsibility.
Answer questions regarding account aging, denial types and other requests for analysis and detail by account, center, denial type or any other claim and invoice characteristics.
Participate as a team player, and have ability to communicate well with team members, patients, customers, insurance carriers, etc.
Apply the appropriate strategy to account resolution including thresholds for refunds, recoups, write offs, adjustments and productivity targets.
May work payments, adjustments, claims, correspondence, refunds, denials, financial/charity applications, and/or payment to help the team meet goals in work quality and productivity.
Identifies payer, center, and denial trends and shares those results with collections leaders.
Performs all functions according to established policies, procedures, regulatory and accreditation requirements, as well as applicable professional standards.
Provides all customers with an excellent service experience by consistently demonstrating our core and leader behaviors each and every day.