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Patient Accounts Biller/Collector

Category:

Patient Accounting

Department:

Patient Accounting

Status:

PRN

Schedule:

Days

Description:

Minimum Entry Level Qualifications

  1. Experience and/or level of competency: Thorough understanding of different insurance plans, government agencies, Medicare and Medicaid. Previous insurance collections experience. Ability to communicate in English, both verbally and in writing. Other languages preferred. Basic computer knowledge. Correct and safe operation of office equipment, i.e., copy machine, adding machine, fax.
  1. Academic Preparation: High school graduate or equivalent.

General Description:

Responsible for the collection of payments that are billed to Medicare, Medicaid, Commercial Carriers and other plans. Makes and answers phone calls received from insurance companies in reference to payments and questions on the accounts. Collects payments from commercial insurance companies, state and federal agencies. Participates in performance improvement and continuous quality improvement (CQI) activities.

Specific Responsibilities:

  1. Contacts daily by phone and/or an electronic process to Medicare, Medicaid, Commercial Insurance, and Third Party Payers to collect payments from the insurance carriers.
  2. Documents all correspondence and conversations with insurance companies, Medicare, Medicaid, Commercial Insurance, third party payers, and patients on the patient’s account file.
  3. Appeals claims as soon as the denial is posted to the patient account file.
  4. Demonstrates the ability to answer phone calls in a concise tactful, courteous manner and functions well in stressful situations.
  5. Demonstrates knowledge and understanding of insurance guidelines for Medicare, Medicaid, private insurance, workers compensation, etc.
  6. Demonstrates the ability to work independently to resolve account problems.
  7. Contacts and reviews the time pay accounts that are delinquent for payments and apply policy and procedures.
  8. Adjusts patients’ bills on contractual, to reflect the correct balance to the patient account.
  9. Communicates to the Cashier those payments that need to be corrected to the patients account.
  10. Stays informed of changes to the insurance industry.
  11. Always accepts other duties assignments as needed.
  12. Maintains a good working relationship within the department and with other departments of the hospital.
  13. Communicates clearly and accurately with the Business Office Supervisor and Patient Financial Services Director.
  14. Performs other related duties as assigned.
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