- Collect delinquent outstanding balances as quickly as possible by applying collection best practices for Managed Medicaid, Medicaid, Self-Pay, and other reimbursement categories.
- Review and effectively research assigned accounts on worklist and third party remittances to determine accounts requiring action.
- Collects/analyzes payer data using remittances, web portals or initiating collection calls to determine root cause of open, denied, underpaid and overpaid claims with a solutions focus in a timely manner.
- Completes appropriate follow-up action as necessary; Keeps current with third party payer rules and regulations.
- Document all actions taken on accounts in central documentation system and worklist’s.
- Presents AR analysis to appropriate managers and administration on a weekly and monthly basis through various report mechanisms to identify issues and action taken and proposed next steps.
- Proactively tracks status trend issues that are reported to Supervisor.
- Participate in weekly and bi-weekly meetings with respective branch managers regarding status of A/R.
- Prepare weekly AR summaries and monthly open claims reports categorized by root issue, claim amount, action required. Report any discrepancies or inconsistencies in data and/or reports to management timely.
- Recommended write-offs to management as needed after exhausting all collection effort per policies and procedures.
- Recommend accounts to be placed for third party collection and escalate special projects to third party insurance administration with high data integrity.
Experience & Skills Required
- 2+ years’ experience in Collections.
- Healthcare experience preferred
- Excellent verbal and written communication skills.
- Expert in Microsoft Office and Billing and Collections software
- Travel may be required for business purposes. If so, the employee must have a valid driver’s license issued by the state in which they work and a satisfactory driving record.