Collections Representative

Job Description

Description:

This role will provide billing investigation, follow up related to patient/customer complaints and advocacy for patients related to complaints or billing issues. Ensure proper submission and adjudication on all claims submitted to third party carriers, Medicaid, Medicare. Respond to all inquiries according to PFS policy and procedures.

This job is fully on-site and Monday- Friday.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

1. Advocate for patients regarding complaints or billing issues.

2. Provide account resolution, within HFMA Patient Friendly requirement and document all activity on accounts.

3. Identify any issues, that causes delay in payment, or repetitive errors.

4. Ensure compliance with all state and federal billing regulations.

5. Complete the follow-up of claims when an error is identified and account follow-up goals.

6. Submit the necessary re-bill for the claim, monitor and expedite by contacting the assigned payor representatives.

7. Assist patient in setting up mutually agreeable payment arrangements.

8. Review payment denials and discrepancies identified through EOB, Remittance Advices or Payor correspondence.

9. Contact various departments throughout Community First Medical Center to obtain additional information.

10. Post all payments and adjustments to the appropriate patient accounts.

Community First Medical Center offers benefits to all its full-time and part-time employees: United Healthcare Medical PPO/HMO Plans MetLife Dental MetLife Vision 6 Paid Holidays Paid Time Off Company Paid Short-term Disability Company Paid Life Insurance 401(k) Voluntary Benefits: Hospital Indemnity & Critical Illness Tuition Reimbursement & Continuing Medical Education Requirements:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required.

EXPERIENCE AND EDUCATION

Knowledge and ability to apply high level of knowledge of respective insurance billing regulations and guidelines

Able to communicate clearly and professionally and have excellent interpersonal, verbal communication skills

Must have High School degree or equivalent, Assoc. degree preferred

Three+ yrs. in patient accounting, specifically billing and/or collections in the assigned insurance area

Community First Medical Center is an affirmative action/equal opportunity employer who is committed to cultivating diversity, equity and inclusion within all aspects of our organizations. We stand against and prohibit discrimination in hiring or employment on the basis of age, sex, race, color, religion, national origin, gender identity, veteran status, disability, sexual orientation or any other protected status.

Part-time