- Only those lawfully authorized to work in the designated country associated with the position will be considered.
- Please note that all Position start dates and duration are estimates and may be reduced or lengthened based upon a client’s business needs and requirements.
- The Collector Appeal Specialist is responsible for accurately processing inpatient and out-patient claims to third party payers and private pays, following all mandated billing guidelines.
- Responsible for ensuring timely filing and guidelines are met; provided quality control checks on paper and electronic claims;
process tracers, denial and related correspondence; initiate appeals; compose and submit appeal letters specific challengeable denial issues consistent with the most update American Medical Association Current Procedural Terminology.
- Must demonstrate a positive demeanor, good verbal and written skills, and must be professional in both appearance and approach.
- Will maintain consistent productivity standards as appropriate for their unit as well as maintain an average of 90% (score 9.
0) or better on Quality Reviews.
- The Professional Billing Refund Collector is responsible for accurately reviewing credit balances and processing adjustments, transfers and refunds as needed.
- Helps in billing operations by providing support and research of misapplied payments.
- Works as a member of the billing team to provide smooth operational flow resulting in optimum customer (internal / external) satisfaction and effective / efficient processes.
TYPE OF SUPERVISION RECEIVED :
- Direct supervision required.
- Daily, weekly and / or monthly Unit meetings may be required.
- Direct review of daily production and other production-based reports to validate staff usage needs, portfolio reduction efforts, customer services and staff morale.
Must-Haves
- Minimum of 4 years of experience in profee billing with PPOs and HMOs
- Strong communication skills, both written and oral, with comprehensive knowledge of applicable collection laws, policies, and principles governing collection efforts, as well as expertise in problem identification and resolution, insurance, medical terminology, and reimbursement procedures
- Demonstrated expert-level proficiency in a specialty area
- Experience working in diverse computing environments
Nice to Have
Ability to learn new billing systems quickly
What is the required levels experience, education?
High School Diploma
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