About the Role

This function is responsible for Collections for Healthcare unpaid claims. The position in this function interact with customers gathering support data to ensure invoice accuracy and also work through specific claims discrepancies. Provide input to policies, systems, methods, and procedures for the effective management and control of the premium collection function. Educate customers regarding the availability of receiving claims and remitting payments through online applications. Monitor outstanding balances and take appropriate actions to ensure clients pay as billed. Manage the preparation of invoices and complete reconciliation of billing with accounts receivables. May also include quality assurance and audit of collection activities.

Blended Account process documents, emails and calls.

Moderate work experience within own function.

Some work is completed without established procedures.

Basic tasks are completed without review by others.

Supervision/guidance is required for higher level tasks.

Return to office set-up (QC Office)

Primary Responsibilities:

Contract reading of payment dispute.
Working on the Provider side.
Checking with the insurance to verify claim status and collect unpaid claims.
Process claims payment.

Required Qualifications:

• College graduate

• At least 12 months of RCM AR Follow-Up experience

• Experience handling unpaid, underpaid, rejected, and denied claims

• Strong appeal letter writing and account documentation skills

• Knowledge of payer guidelines, timely filing, and denial resolution

• Strong analytical, communication, and problem-solving skills

• Used and familiar with EPIC SYSTEM is an advantage.

• Proficiency with Windows PC applications, which includes the ability to navigate multiple programs and learn new and complex computer system applications.

• Ability to multi-task and to understand multiple products and multiple levels of benefits within each product.

What makes this a special challenge For one, we want to create a quality experience for every person we serve. So the bar is high for accuracy, communications style and effectiveness. Also, you'll need to be researching and resolving problems before, during and after calls within a high volume, demanding environment.

WHAT WE OFFER

Laptop/Computer Provided by the Company
Market Total Rewards Package
Retirement Plan
Medical Plan (HMO) from Day 1 of employment
Dental, Medical, and Optical Reimbursements
Life and Disability Insurance
Paid Time-Off Benefits
Sick Leave Conversion
Tuition Fee Reimbursement
Employee Assistance Program (EAP)
Annual Performance Based Merit Increases
Employee Recognition
Training and Staff Development
Employee Referral Program
Employee Volunteerism Opportunity
All Mandatory Statutory Benefits

US Healthcare AR Follow-Up & Collections Specialist (Revenue Cycle Management)