Responsible for the collections of unpaid medical insurance claims, and follow up on unpaid medical claims, as well as appealing these claims.
Specific duties & responsibilities:
Uses system collection reports, such as: aged trial balances, data search reports, and the Paperless Collection System (PCS) to identify unpaid claims for collection/appeals.
Communicates with third-party payers, patients, physicians, and other parties to resolve unpaid claims.
Reviews and updates patient registration information (demographic and insurance) on IDX as needed.
Utilizes PCS to process A/R. Works PCS files to completion.
Applies appropriate discounts/courtesies based on department policy.
Prints and mails claim forms and statements according to the follow-up matrix. Retrieves supporting documents (medical reports, authorizations, etc.) as needed and submits to third-party payers.
Identifies and informs the Supervisor/Production Unit Manager of issues or problems associated with non-payment of claims.
Appeals rejected claims and claims with low reimbursement.
Identifies and informs management of systems or operational issues affecting collections, reimbursement and/or day in accounts receivable.
Processes third-party payer correspondence for resolution and/or payment of claims.
Researches and resolve Production Unit posting errors during the month.
Other duties and special projects as assigned.
Minimum qualifications (mandatory):
High school diploma/GED required.
One (1) year of medical billing experience required.
Knowledge of medical terminology, CPT codes and ICD-9 codes required
Two years' experience preferred.
Ability to use various billing and patient information computer systems preferred. Knowledge of various payer processing and submission guidelines preferred.
Experience in IDX and PCS preferred.
Knowledge of third party payer requirements.
Special knowledge, skills, and abilities. Proficiency with IBM personal computers to include Word, spread sheeting in either Lotus or Excel and possible database experience. Capable of meeting deadlines and focusing on details. Has excellent customer service and communication skills, ability to diffuse difficult situations in a complex environment. Has good understanding of third party reimbursement policies and protocols.
Classified Title: Collection Specialist Working Title: Collection Specialist Role/Level/Range: ATO 40/E/02/OC Starting Salary Range: $13.36-$18.41(commensurate with experience) Employee group: Full Time Schedule: Monday- Friday 8:30 AM - 5 PM Exempt Status: Non-Exempt Location: 16-MD:JH at White Marsh Department name: 10003011-SOM Ortho Production Unit Billing Personnel area: Johns Hopkins University
The successful candidate(s) for this position will be subject to a pre-employment background check.
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