Medicare Collector

Position Summary To succeed in this role, you must possess in-depth knowledge of Government Payor collections practices and insurance policies. The ideal candidate must also be able to demonstrate excellent written and verbal communication skills, as communicating with various insurance companies, plan administrators, team members and customers. This position requires a driven individual that can multi-task, problem solve, and manage workload and time effectively. Able to manage stress. Job Requirements/Qualifications Experience with Medicare/Medicare Advantage Plan collections is a must. (Please specify detailed experience on resume/application for consideration) At least 5 years Medicare/Medicare Advantage Plan Insurance Collection experience required. Strong working knowledge of Medicare Part B billing and reimbursement guidelines. Preferred experience in Hospice, Skilled Nursing Facilities (SNF) and Inpatient stays with a specific knowledge and focus on collections and outstanding receivables. Recent experience with Hospitals, Ambulance or Freestanding Emergency Room insurance collections preferred. Medical necessity requirements (LCDs/NCDs) / Modifiers and correct coding impacts on reimbursement. Knowledge of identifying payer denials and appeal processes. Experience with creating appeals and grievances required. Knowledge of various medical benefit coverages and plan funding types. Organized, dependable, self-sufficient, hardworking, analytical, and detail orientated. Knowledge of Authorizations, Payment Posting, Reimbursement and Billing - full Revenue Cycle. Strong understanding of professional claims (CMS-1500) and reimbursement methodologies Ability to read the Explanation of Benefits [EOB] from various payers. Strong phone etiquette with exceptional customer service skills. Ability to work through stressful situations professionally and respectfully. Microsoft Office 365 proficiency, specifically Excel. Essential Job functions and responsibilities The AR workflows include back-end collections and billing for Medicare and Medicare Advantage Plan accounts. Receives, investigates, and responds to inquiries from payors. Actively follow-up and collect on all outstanding electronic or paper submission claims by either phone or payer portals. Review Insurance EOB and initiate considerations or appeals as necessary. Take initiative and able to work independently. Managing a high productivity workload. Identify and report all payer issues to management. Understand and comply with all governmental, regulatory, billing, compliance regulations and corporate policies. Detail oriented and proficient in researching payer fee schedules, guidelines, medical and reimbursement policies. Strong ability to communicate with plan administrators, insurance companies and patients in a professional and respectful manner.

Job Type:

Full-time Experience:

Medicare Collections:

5 years minimum (Required)

Education:

High school or equivalent (Required)

Job Type:

Full-time Benefits:

401(k) matching Dental insurance Health insurance Life insurance Paid time off Vision insurance

Education:

High school or equivalent (Preferred)

Experience:

Medicare Collection:

5 years (Required)

Work Location:

In person