About the role
- Perform payment follow-up activities on assigned patient accounts.
- Conduct collection activities by contacting government agencies, third-party payers, or patients via phone, email, or online portals.
- Continue follow-up efforts until the account is resolved, paid, or appropriately escalated.
- Review and address previously appealed claims, ensuring timely responses from payers.
- Request and track additional documentation from internal departments or patients as needed.
- Research payer plans and verify benefit coverage to resolve claim discrepancies.
- Identify billing or coding issues and request re-bills, secondary billing, or corrected claims as required.
- Monitor payer trends and escalate recurring issues or delays to management.
- Maintain productivity and quality standards for assigned accounts.
- Ensure compliance with all federal, state, and payer-specific regulations related to medical collections and appeals.
- Collaborate with other departments to ensure efficient resolution of account issues.
Requirements
- High school diploma or equivalent required; post-secondary education in billing or healthcare administration preferred.
- Minimum 1–2 years of experience in medical billing, collections, or accounts receivable follow-up.
- Solid understanding of the revenue cycle process, including patient access, billing, and collections.
- Working knowledge of Managed Care, HMO/PPO, Medicare/Medicaid, and commercial payer guidelines.
- Familiarity with UB-04 and HCFA 1500 billing forms.
- Strong analytical and problem-solving skills with attention to detail.
- Excellent written and verbal communication skills.
- Ability to meet daily productivity and accuracy standards.
- Proficiency in Microsoft Office and experience with billing or claim management systems preferred.
- Health insurance
- Flexible work arrangements
- Professional development opportunities
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
medical billingcollectionsaccounts receivablerevenue cycle processManaged CareHMOPPOMedicareMedicaidbilling forms
Soft skills
analytical skillsproblem-solving skillsattention to detailwritten communicationverbal communicationproductivityaccuracy