Collection Specialist, Outreach Lab

Collection Specialist, Outreach Lab DHR Health - 2.9 Edinburg, TX Job Details Full-time 18 hours ago Qualifications Spreadsheets Workers' compensation insurance knowledge High school diploma or GED Typing Productivity software Full Job Description DHR Health -

US:

TX:

Edinburg -

Days Summary:

POSITION SUMMARY

This position is responsible for activities leading to the collection of accounts receivable that are outstanding on the ATB, utilizing verbal and written communications with insurers, providers, employers, patients and other payers. This position requires being familiar with patient, commercial, workers compensation, and liability third party payer reimbursement, and is accountable for getting those accounts collected.

POSITION EDUCATION/ QUALIFICATIONS

High school diploma/ GED is required Comprehensive knowledge of healthcare reimbursement Understands medical terminology Knowledge of Microsoft Office suite, working knowledge of Excel required Excellent Customer Service Good written and verbal communication skills required. Must be able to multi-task Ability to read, write and speak English. Ability to communicate clearly and concisely with all levels of management Previous healthcare experience (1-2 yrs.) is required, hospital experience preferred.

JOB KNOWLEDGE/EXPERIENCE

Minimum of 1-2 yrs. experience with medical collections, managed care contract experience is preferred. Communicates clearly and concisely and is able to work effectively with other employees, patients and external parties Provides excellent customer service by establishing and maintaining long-term relationships with carrier reps. Demonstrates proficiency in Microsoft Office applications, be able to type at least 35 WPM, and good working knowledge of Excel is required. Able to perform basic mathematical calculations, balance and reconcile figures, punctuate properly and spell correctly. Ability to use the internet to obtain claim status with Third Party Payers. Requires working with minimal to moderate interruptions

Responsibilities:

POSITION RESPONSIBILITES

Promotes the facility mission, vision and values by effectively communicating them to others. Considers mission, vision and values in developing services, standards and practices Responsible for following up insurance accounts assigned on ATB report and Tickler report Contacts insurance carrier for payment on assigned accounts Follows-up on an accounts daily and completes 100% of the assigned accounts by the end of each week. Adheres to collection tips booklet when contacting insurance carrier. Proficient in accessing information from revenue cycle software Reviews accounts to ensure the appropriate insurance plan is set-up and the correct insurance adjustment was posted. Reads previous notes on the account and document new notes using appropriate mnemonic in the notes tab Familiar with managed care contract terms to determine appropriate reimbursement of insurance carrier Ability to compare the payer reimbursement to the expected payment in the computer and question any discrepancies with insurance carrier when on the phone Ability to identify accounts that need insurance billing or rebilling i.e., late charges Contacts physician's office and request copies of documentation needed Request copies of medical records from HIM for any paper records as needed Ability to obtain electronic records from the Cerner system as needed Contacts patient to ensure all requested information for insurance company is provided. Daily follow up on faxes or messages to carriers within 24 hours, to ensure the fullest collection effort is accomplished. Provide excellent customer service by responding to carriers or patient calls within 24 hours and documents activity on the patient account. Assist other collectors in collecting a difficult account as needed Select correct adjustment codes on letter to appropriately document reason for adjustment Provide assistance with the Customer service front desk, as needed. Assign appeal agency code to the accounts that need to be followed up by the appeals area. Complete adjustment form appropriately with the correct dollar amounts assigned to the codes Responsible to complete all tasks assigned daily. Ensures patient confidentiality requirements are met in accordance with HIPAA policies and procedures. Other duties as assigned.

Other information:

LINES OF REPSONSIBILITES

(Chain-of-command) 1. Outreach Billing Manager 2.Outreach Billing Director 3.Outreach Administrator

CUSTOMER SERVICE

Provide excellent customer service to all DHR customers. All employees are required to attend the

DHR C.A.R.E.S

program which outlines the Customer Service Principals including: Commitment, Accountability, Respect, Excellence and Service.

AGE SPECIFIC

Employees must be able to demonstrate the knowledge and skills necessary to provide care appropriate to the age of the patients served in his/her assigned unit. The individual must demonstrate knowledge of principles of growth and development over the life span and possess the ability to assess data reflective of the patient's status and interpret the appropriate information needed to identify each patient's requirement relative to his or her age.

AMERICANS WITH DISABILITIES ACT

(ADA): A.

Essential Duties:

Indicated by bold print within performance standards, preceding individual numbered criteria. The following table provides physical requirements that will be associated with, but not limited to, this position: Light/moderate lifting up to 20 lbs, from the floor to shoulder height. Yes Kneeling Yes Must be able to assist other employees with lifting more than 20 lbs. Yes Walking Yes Light/moderate carrying up to 20 lbs. Yes Standing/Squatting Yes Straight pulling Yes Sitting Yes Pulling hand over hand Yes Pushing Yes Repeated bending Yes Stooping/Bending Yes Reaching above shoulder Yes Climbing Stairs Yes Simple grasping Yes Climbing Ladders No Dual simultaneous grasping Yes Depth Perceptions needed Yes Ability to see Yes Identify Colors Yes Operating office equipment Yes Twisting Yes Operating mechanical equipment Yes Crawling No Ability to read and write Yes Ability to Count Yes Ability to hear verbal communication without aid Yes Operating Personal Vehicle Yes Ability to comprehend written/verbal communication

Yes Other:

Ability to deal with stress Yes OSHA Category III • B.

Working Conditions:

The individual spends over 95% of his/her time in an air-conditioned environment with varying exposures to noise. There is protection from weather conditions but not necessarily from temperature changes. The position does have low exposure to malodorous, infectious body fluids from patients and some minimal exposure to noxious smells from cleansing agents. C.

Occupational Exposure:

This position has minimal to no exposure to blood, body fluids, or tissues and is an OSHA Category III (although situations can be imagined or hypothesized under which anyone, anywhere, might encounter potential exposure to body fluids). Person who performs these duties are not called upon as part of their employment to perform or assist in emergency medical care or first aid or to be potentially exposed in some other way. D.

Aptitudes:

HIGH 1 2 3 4 5 6 LOW

Intelligence:

General learning ability: The ability to "catch on" or understand instructions and underlying principles. Ability to reason and make judgments. 3

Verbal:

Ability to understand meanings of words and ideas associated with them, and to use them effectively. To comprehend language, to understand relationships between words, and to understand meanings of whole sentences and paragraphs. To present information or ideas clearly. 3

Numerical:

Ability to perform arithmetic operations quickly and accurately. 2

Spatial:

Ability to comprehend forms in space and understands relationships of plane and solid objects. Frequently described as the ability to "visualize" objects or two or three dimensions, or to think visually of geometric forms. 2

Form Perception:

Ability to perceive pertinent details and objects or in pictorial or graphic material to make visual comparisons and discriminations and see slight differences in shapes and shadings of figures and widths and lengths of lines. 3

Clerical Perception:

Ability to receive pertinent details and verbal or tabular material. To observe differences in copy, to proofread words and numbers, and to avoid perceptual errors in arithmetic computation. 2

Motor Coordination:

Ability to coordinate eyes and hands to fingers rapidly and accurately in making precise movements with speed. Ability to make a movement response accurately and quickly. 3

Finger Dexterity:

Ability to move hands easily and skillfully. To work with fingers in placing and turning motions. 3

Manual Dexterity:

Ability to move hands easily and skillfully. To work with hands in placing and turning motions. 3

Eye-Hand-Foot Coordination:

Ability to move the hand and foot coordinately with each other in accordance with visual stimuli. 3

Color Discrimination:

Ability to perceive and respond to similarities or differences in colors, shapes, or other values of the same or different color. To identify a particular color, or to recognize harmonious or contrasting color combinations, or to match color adequately. 3 I have read and reviewed my job description with my supervisor or designee and I understand the job I am expected to perform. If applicable ____________ certification will be completed within _________ time frame of hire/transfer date.

Employee Signature:

________________________________

Date:

____________________

Transfer/Hire Date Effective:

________________________.