Underpayment & Overpayment Collector – Healthcare (REMOTE)

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    "ExternalDescriptionStr": "<p><strong>Job Summary</strong><br><br>The Payment Compliance &amp; Contract Management (PCCM) Collector is responsible for the timely and efficient resolution of underpaid and overpaid accounts. This role involves managing account follow-up, analyzing trends, collaborating with internal departments, and ensuring accurate reconciliation of account balances. The PCCM Collector assists in optimizing revenue cycle processes and maintaining compliance with contractual agreements.<br><br><strong>Essential Functions</strong></p><ul><li>Manages account follow-up for underpaid and overpaid claims, escalating unresolved issues internally as needed to achieve resolution.</li><li>Reconciles account balances and adjustments to ensure accurate financial status and compliance with contractual terms.</li><li>Resolves underpayments by engaging in daily communication with payers and negotiating payment discrepancies.</li><li>Identifies and analyzes trends in underpayments, overpayments, denials, and revenue opportunities to recommend process improvements.</li><li>Evaluates and interprets contract reimbursement details, providing feedback and insights to the department to enhance revenue cycle performance.</li><li>Collaborates with financial and clinical departments to address account discrepancies and ensure effective revenue management.</li><li>Reviews contract validation, updates, and provides interpretation to support accurate claim processing and collections.</li><li>Ensures thorough and accurate validation of account analysis before distribution, maintaining compliance with policies and procedures.</li><li>Performs other duties as assigned.</li><li>Maintains regular and reliable attendance.</li><li>Complies with all policies and standards.</li></ul><p><strong>Qualifications</strong></p><ul><li>H.S. Diploma or GED required</li><li>Associate Degree or higher preferred</li><li>1-2 years of experience in healthcare collections, revenue cycle, or contract management required</li><li>Familiarity with payer contracts and healthcare reimbursement methodologies preferred</li></ul><p><strong>Knowledge, Skills and Abilities</strong></p><ul><li>Strong analytical and problem-solving skills.</li><li>Proficient in understanding and interpreting payer contracts and reimbursement terms.</li><li>Effective communication and negotiation skills.</li><li>Ability to work independently and manage multiple priorities in a fast-paced environment.</li><li>Proficiency in healthcare billing software, Google Suite, and Microsoft Office Suite, especially Excel.</li><li>Attention to detail and high degree of accuracy in reconciliation and analysis.</li></ul>",
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