Collection Specialist will follow-up with insurance companies to collect outstanding accounts for which payment has not been received in response to the claims submission process, either electronically or by paper. The Specialist will be assigned payor groups of outstanding patient accounts. Various methods of follow-up will be used include EPIC and payor websites. The specialist must have expertise in insurance follow-up processing and be knowledgeable in CPT codes and ICD-10-CM coding as well as have an understanding of the registration process and be able to recognize and resolve incorrect demographic and insurance registration. The Specialist must have an understanding of claims submission requirements for all payers to expedite payments as well as knowledge of appeals and rejections processing. This person must have excellent communication skills coupled with patience and fortitude.
Specific duties & responsibilities:
Identifies problem issues on outstanding patient accounts. Works to resolve issues so that invoices will be processed by the payor or balance moved to patient responsibility.
Identifies insurance issues of primary vs secondary insurance, coordination of benefits, Eligibility and any other issue causing non-payment of claims. Contacts the payor or patient as appropriate for corrective action to resolve the issue and receive payment of claims.
Alerts the manager to problems with specific carrier payments, improper rejections or Non-compliance with Maryland law when the issue cannot be resolved or if there seems to be a trend with a particular payor.
Handles patient account inquiries and assists patients with filing or re-filing of claims including secondary insurance.
Communicates with patients and insurance companies to resolve accounts. This includes resolving issues identified through incoming correspondence.
Print and mail/fax claim forms and statements as requested by patients, insurance companies or other authorized third parties.
Prints medical notes from the EPIC system when needed for the processing of claims.
Working knowledge of EPIC registration systems.
Special knowledge, skills, and abilities:
Working knowledge of EPIC registration systems.
Expertise in insurance follow-up processing and be knowledgeable in CPT codes and ICD-10-CM coding as well as have an understanding of the registration process and be able to recognize and resolve incorrect demographic and insurance registration.
Understanding of claims submission requirements for all payers to expedite payments as well as knowledge of appeals and rejections processing.
Excellent communication skills coupled with patience and fortitude.
High school diploma or GED. At least one year experience in a specialty or medical environment is required. Additional education may substitute for required experience to the extent permitted by the JHU equivalency formula.
JHU Equivalency Formula: 30 undergraduate degree credits (semester hours) or 18 graduate degree credits may substitute for one year of experience. Additional related experience may substitute for required education on the same basis. For jobs where equivalency is permitted, up to two years of non-related college course work may be applied towards the total minimum education/experience required for the respective job.
Two or three years' experience in medical billing.
Classified Title: CO Collection Specialist Role/Level/Range: ATO/02/0C Salary: $13.23 - $18.23 Status: Full-Time Work Schedule/Hours: m-F 8:30-5:00 Department name: 10003158-SOM Rad Production Unit Billing Location: 02-MD:Mount Washington Campus Personnel area: School of Medicine
The successful candidate(s) for this position will be subject to a pre-employment background check.
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