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Medical Collector
Career Insights for Medical Claims Processor / Representative
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Scorecard
Based on New Jersey data
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What they do
A Medical Claims Processor or Representative reviews and processes medical insurance claims and determines whether an insurance policy will cover a medical procedure. Gathers information from policy holders and organizes insurance files; may process checks with payments to policy holders when a medical claim is approved.
$49,093 / year median in New Jersey
-5% projected decline
Job Description
Medical Collector Centers for Neurosurgery, Spine, and Orthopedics Wayne, NJ Job Details Full-time $27 - $33 an hour 10 hours ago Benefits Health insurance Dental insurance 401(k) Paid time off Vision insurance Qualifications Microsoft Word Microsoft Excel Microsoft Outlook Writing skills High school diploma or GED Medical debt collection accounts Full Job Description Medical Biller/Collector Job Description CNSO is a vibrant, well-established, neurosurgery, spine surgery, orthopedic spine surgery, pain management and physical therapy practice, with multiple office locations throughout Northern New Jersey. Due to continued expansion, CNSO has an exciting opportunity to join its revenue cycle department in its Wayne location. The medical collector should have proficiency and knowledge regarding claims adjudication process, individual insurance policies, CMS guidelines, NCCI edits, and the ability to effectively and professionally communicate with insurance carriers and fellow staff members both verbally and in writing. This Medical Collector position will be responsible for the follow-up and payment of claims. CNSO provides a two-month orientation and training process. The right candidate can work both independently and in a team setting. The revenue cycle department is very organized and has routine and regular educational weekly meetings.
Duties & Responsibilities:
Timely management of assigned medical claims, aging reports, and correspondence. Consistently communicate with insurance companies to address denials, corrected claims, and receipt of appeals. Proactively ensure timely and accurate processing of claims. Utilizes Navinet, Optum, and Availity to understand the status of claims. Adheres to policies and procedures. Accurately identifies the reason for payor denials. Detailed appeal writing that targets the reason for the denial. Identifies the cause of clearinghouse rejections. Ensure the primary payor's claim is always sent to the secondary payor and verify that both parties pay the contracted rate. Answers and resolves all incoming calls, faxes, and emails promptly. Achieves goals established by the Revenue Cycle Manager. Duties as assigned.
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Experience/Training/Education:
High School Diploma or GED
•Must have 3+ years of Medical Collections experience
•Strong Experience in collecting for Physical Therapy, office visits, plastics, or surgery preferred. Experience with in and out of network claims along with NJ PIP and WC Posting knowledge also valued
Knowledge/Skills/Abilities:
Ability to research payor websites and apply insurance guidelines Medicare Medical Billing Outlook, Word, Excel EMRs such as
EclinicalWorks Benefits:
Healthcare Plan Dental and Vision Plan
PTO 401K
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Work Location:
One location-Wayne.
NJ Work Remotely, No Job Type:
Full-time Eligible for semi-annual bonus based on performance evaluation.
Job Type:
Full-time Pay:
$27.00 - $33.00 per hour
Benefits:
401(k) Dental insurance Health insurance Paid time off Vision insurance
Work Location:
In person