The Biller/Collector Specialist is responsible for timely and appropriate billing and collection of monies from payers on specialized accounts. In addition, differentiating the Biller/Collector Specialist from Collectors levels I-III, this position is responsible for providing advanced billing and collection services in the areas of problem identification and resolution, special projects and development of junior staff.
ESSENTIAL JOB DUTIES (May include all or some of the following):
- Completion and submission of clean claims to payers for both hospital and physician billing, either electronically or hardcopy.
- Contacts payers to follow-up on all assigned, unpaid account claims utilizing Company and client systems.
- Follows billing and collection procedures in accordance internal policies
- Initiates proactive measures that result in account resolution on assigned projects involving specialized or advanced issues
- Researches and analyzes accounts payments and credits
- Ensures that all conditions for payment receipt have been satisfied, which includes but is not limited to, accurate charges and financial class; authorization/certification information; claims address; ICD-10 and CPT-4/HCPCS coding; patient insurance eligibility, patient benefit coverage; patient responsibility.
- Responds timely and accurately to all incoming correspondence and inquiries from payers, patients, and other appropriate parties
- Initiates contact with patients, as necessary
- Provides recommendations for resolving accounts
- Evaluates accounts to determine any write-offs or corrections required
- Prepares refund requests for any monies due to patient or insurance company
- Responds to all phone calls from other departments or insurance companies in an efficient and courteous manner
- Handles, in a professional and confidential manner, all correspondence, documentation, and files
- Minimum 1-year experience in billing and collections within hospital and/or physician business office setting.
- Strong understanding of payer regulations and requirements.
- Ability to analyze and resolve complex accounts.
- Strong knowledge of all payer types.
- Ability to accept and manage special projects
- Strong knowledge of CPT-4 and ICD-10 coding
- Understanding of managed care contract reimbursement guidelines
- Ability to work independently and to be proactive in securing payments and resolving issues
- Knowledge of procedures and data flow in a health care organization; experience with physician billing required.
- Excellent verbal and written communication skills in the English language
- Able to work in a team-oriented environment
- Ability to effectively communicate with multiple levels in the health system.
- Minimum high school diploma
Wage range Offered: $14.00-$17.00 (hourly rate is based on experience and is NOT NEGOTIABLE)