Medical A/R Collections Specialist

Summary Responsible for all aspects of Medical A/R collections, claim status and denial management. Essential Duties and Responsibilities include the following. Other duties may be assigned as needed to meet our department productivity standards. Completes follow up on outstanding medical A/R insurance claims with no response directly with payers Works various denials from insurances including coverage in question, medical necessity, re-bundled, incorrect coding, credentialing, etc. Reviews electronic rejections Completes incoming correspondence from patients and or insurance Works with coders on any coding and billing issues to correct and or appeal errors in a timely manner Initiates refund/credit requests. Properly documents the patient account of all steps taken to resolve balance pending by payer or patient Escalate problems with electronic claims submissions and or bulk rejections to manager for assistance and guidance for resolution. Bulk mails all manual claims to individual payers daily as needed Works daily, weekly and monthly aging reports as assigned Education and/or Experience Strong, working knowledge of insurance payers to include government, commercial and managed care products. Ability to establish a good rapport with Clinic managers and Providers. Resourceful, steadfast attitude to make sure that claims are worked timely. Comfortable with navigating through the payer websites for claim status, appeals, etc.. Excellent verbal and oral communication skills. Excellent customer service skills are expected with patients and clinic staff. Other Qualifications Must be able to multitask and demonstrate excellent time management Must work well in a team environment Ability to communicate well with patients and other team members in a tactful and courteous manner Protect PHI and follow HIPPA regulations Required to meet department quality and production standards Maintaining and satisfying minimum attendance requirements is an essential function of this position including working all full-time regular hours as established Knowledge of CPT/HCPCS and

ICD-10. 2

years' experience preferred in a medical office setting. Medical A/R Collections Specialist 2.7 2.7 out of 5 stars 1303 Hospital Boulevard, Floresville, TX 78114 Part-time, Full-time

WILSON COUNTY MEMORIAL HOSPITAL DISTRICT 29

reviews Part-time, Full-time Summary Responsible for all aspects of Medical A/R collections, claim status and denial management. Essential Duties and Responsibilities include the following. Other duties may be assigned as needed to meet our department productivity standards. Completes follow up on outstanding medical A/R insurance claims with no response directly with payers Works various denials from insurances including coverage in question, medical necessity, re-bundled, incorrect coding, credentialing, etc. Reviews electronic rejections Completes incoming correspondence from patients and or insurance Works with coders on any coding and billing issues to correct and or appeal errors in a timely manner Initiates refund/credit requests. Properly documents the patient account of all steps taken to resolve balance pending by payer or patient Escalate problems with electronic claims submissions and or bulk rejections to manager for assistance and guidance for resolution. Bulk mails all manual claims to individual payers daily as needed Works daily, weekly and monthly aging reports as assigned Education and/or Experience Strong, working knowledge of insurance payers to include government, commercial and managed care products. Ability to establish a good rapport with Clinic managers and Providers. Resourceful, steadfast attitude to make sure that claims are worked timely. Comfortable with navigating through the payer websites for claim status, appeals, etc.. Excellent verbal and oral communication skills. Excellent customer service skills are expected with patients and clinic staff. Other Qualifications Must be able to multitask and demonstrate excellent time management Must work well in a team environment Ability to communicate well with patients and other team members in a tactful and courteous manner Protect PHI and follow HIPPA regulations Required to meet department quality and production standards Maintaining and satisfying minimum attendance requirements is an essential function of this position including working all full-time regular hours as established Knowledge of CPT/HCPCS and

ICD-10. 2

years' experience preferred in a medical office setting.