Underpayment & Overpayment Collector – Healthcare (REMOTE

Community Health Systems Professional Services Corporation•Antioch, TN

11d•Remote

About The Position

The Underpayment & Overpayment Collector – Healthcare (REMOTE) is responsible for the timely and efficient resolution of underpaid and overpaid accounts. This role involves managing account follow-up, analyzing trends, collaborating with internal departments, and ensuring accurate reconciliation of account balances. The PCCM Collector assists in optimizing revenue cycle processes and maintaining compliance with contractual agreements. As a Payment Compliance Collector at Community Health Systems (CHS) - PCCM, you’ll play a vital role in supporting our purpose to help people get well and live healthier by providing safe, quality healthcare, building enduring relationships with our patients, and providing value for the people and communities we serve. Our team members enjoy a robust benefits package including medical, dental and vision, insurance, and 401k. The Payment Compliance and Contract Management (PCCM) team plays a critical role in ensuring that payments are made according to contractual agreements and regulatory requirements. The team oversees the full contract lifecycle, focusing on analyzing reimbursement discrepancies, improving revenue cycle processes, and ensuring compliance with contract terms to support financial accuracy and operational efficiency. Community Health Systems is one of the nation's leading healthcare providers. With healthcare delivery systems in 36 distinct markets across 14 states, CHS operates 69 affiliated hospitals with more than 10,000 beds and approximately 1,000 other sites of care, including physician practices, urgent care centers, freestanding emergency departments, imaging centers, cancer centers, and ambulatory surgery centers.

Requirements

H.S. Diploma or GED required
1-2 years of experience in healthcare collections, revenue cycle, or contract management required
Familiarity with payer contracts and healthcare reimbursement methodologies preferred
Experience in hospital insurance collections strongly preferred
UB-O4 experience strongly preferred
Strong analytical and problem-solving skills.
Proficient in understanding and interpreting payer contracts and reimbursement terms.
Effective communication and negotiation skills.
Ability to work independently and manage multiple priorities in a fast-paced environment.
Proficiency in healthcare billing software, Google Suite, and Microsoft Office Suite, especially Excel.
Attention to detail and high degree of accuracy in reconciliation and analysis.

Nice To Haves

Associate Degree or higher preferred
Familiarity with payer contracts and healthcare reimbursement methodologies preferred
Experience in hospital insurance collections strongly preferred
UB-O4 experience strongly preferred

Responsibilities

Manages account follow-up for underpaid and overpaid claims, escalating unresolved issues internally as needed to achieve resolution.
Reconciles account balances and adjustments to ensure accurate financial status and compliance with contractual terms.
Resolves underpayments by engaging in daily communication with payers and negotiating payment discrepancies.
Identifies and analyzes trends in underpayments, overpayments, denials, and revenue opportunities to recommend process improvements.
Evaluates and interprets contract reimbursement details, providing feedback and insights to the department to enhance revenue cycle performance.
Collaborates with financial and clinical departments to address account discrepancies and ensure effective revenue management.
Reviews contract validation, updates, and provides interpretation to support accurate claim processing and collections.
Ensures thorough and accurate validation of account analysis before distribution, maintaining compliance with policies and procedures.
Performs other duties as assigned.
Complies with all policies and standards.