Medical Collector I

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    "requisitionDescription": "<div><div><div><div><div><div><p>The Medical Collector I is a full-time position responsible for managing denials and collecting outstanding account receivables securing payment of denied claims for Medical, Dental, Optometry, Behavioral Health, OB-GYN, and Podiatry, claims. This is a challenging and rewarding position that requires strong communication skills, attention to detail, and the ability to work in a fast-paced environment. This position reports to the Billing Manager, in some cases, the focus may be on either coding or billing but must be cross trained in both.</p><p id=\"isPasted\"><strong>Benefits</strong>:</p><ul type=\"disc\"><li>Free Medical, Dental &amp; Vision</li><li>13 Paid Holidays + PTO</li><li>403 (B) retirement match</li><li>Life Insurance, EAP</li><li>Tuition Reimbursement</li><li>Flexible Spending Account</li><li>Continued workforce development &amp; training</li><li>Succession plans &amp; growth within</li></ul><p><strong id=\"isPasted\">Qualifications/Licensure:</strong>&nbsp;</p><p id=\"isPasted\"><strong>Education, Experience, &amp; Knowledge</strong></p><ul><li>Three (3) years of experience with revenue cycle operations management with excellent presentation and writing skills.&nbsp;</li><li>Advanced skills in analysis and MS Office suite.&nbsp;</li><li>eClinical Works experience is preferred.</li><li>High School diploma or GED required.&nbsp;</li><li>Billing Certification required.&nbsp;</li><li>Demonstrated knowledge of all Insurance companies, HMO&rsquo;s, PPO&rsquo;s Government and State programs Medi-Cal and Medicare, and third-party payers.</li><li>Experience with managing revenue cycle processes including Medicaid and Medi-Cal eligibility, health information management and billing, and charge capture processes.</li></ul><p><strong id=\"isPasted\">Responsibilities:</strong></p><p id=\"isPasted\">Performs a combination, but not necessarily all, of the following duties:</p><ul><li>The billing department encompasses medical coding, charge entry, claims submissions, payment posting, accounts receivable follow-up, and reimbursement management.</li><li>Works through patient insurance documentation, billing and collections, and data processing to ensure accurate billing and efficient account collection.</li><li>Analyzes billing and claims for accuracy and completeness; submit claims to proper insurance entities and follow up on any issues.</li><li>Follows up on claims using various systems, such as eClinical Works, Claim Remedi clearinghouse, Medicare DDE, Online payer sites, etc.</li><li>Maintains contacts with other departments to obtain and analyze patient information to document and process billings.</li><li>Analyzes trends impacting charges, coding, collection, and accounts receivable.</li><li>Successfully scrubs and quality controls claims prior to submission.</li><li>Works the A/R, works rejected claims, and provides necessary follow-up to ensure successful claim processing.</li><li>Generate month end close patient financial communication letters and statements</li><li>Provide quality control checks of denied claims, the ability to process tracers, process contractual adjustments and allocation of funds; initiate appeals</li><li>Evaluate remittance to ensure accuracy and analysis of CAS and denial codes.</li><li>Maintains strong attention to detail and ability to multi-task.</li><li>Maintains extremely high standards of professional conduct.</li><li>Establishes and maintains effective working relationships with the office staff and Doctors.</li><li>Adheres to policies regarding safety, confidentiality, and HIPAA guidelines.</li><li>Ensures that the activities of the collection operations are conducted in a manner that is consistent with overall department protocol and are in compliance with Federal, State, and payer regulations, guidelines, and requirements.</li><li>Serves as a practice expert and go-to person for denials questions and advice.</li><li>Performs other job duties as assigned.</li></ul><p><strong id=\"isPasted\"><strong id=\"isPasted\">St. John&rsquo;s Community Health is an Equal Employment Opportunity Employer</strong></strong></p></div></div></div></div></div></div>\n",
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