About the role
- Follow-up with insurance payers on outstanding claims
- Break down obstacles to payment and accelerate cash collections
- Responsible for follow-up and collecting on accounts in assigned inventory
- Utilizes experience and follow-up strategies and tools to resolve claims and obtain payment
- Escalates unpaid claims to payer claims supervisor as appropriate
- Documents client’s host system utilizing the 5 W’s framework
- Writes first and second level appeals of all denials
- Maintains client and/or position specific daily productivity and quality expectations
- Researches and analyzes any correspondence received related to assigned accounts
Requirements
- High school diploma or equivalent
- 3-5 years of collections experience in a Hospital Business Office
- Direct account follow-up and/or billing experience
- Medical Terminology, ICD-10, CPT and DRG knowledge preferred
- Knowledge of third-party Insurance payer guidelines
- Intermediate experience in Excel preferred
- Must be detail oriented, organized, and possess the ability to apply critical thinking skills.
- Work from home and remote location with a stable internet connection
- Daily communication with team members, management, and clients through email, phone calls, video meetings and other collaborative tools
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
collections experiencebilling experienceMedical TerminologyICD-10CPTDRGthird-party Insurance payer guidelinesExcelclaims follow-upappeals writing
Soft skills
detail orientedorganizedcritical thinking
Certifications
high school diploma or equivalent