Description

SUMMARY/OBJECTIVE

The Insurance Collector is responsible for contacting insurance companies to negotiate denials and appeal claims that have been denied from office visits and clinical procedures. All employees are expected to exhibit professional, ethical and respectful behavior in accordance with the company's mission, vision and values.

ESSENTIAL FUNCTIONS

Responsible for reviewing, correcting and releasing Epic Care charges

Demonstrate strong understanding and utilization of Navicure clearinghouse claims tool and Navicure rejection queue

Responsible for researching, correcting and releasing accounts within AFF AFC Claim Edit Billing Work queue

Demonstrate comprehension and implementation of claim appeal process

Knowledge of insurance processes and Medicare rules and guidelines

Identify insurance company or proper party (patient) to be billed secondary or tertiary insurances

Communicate with health care providers, patients, insurance claim representatives and other parties to facilitate payment

Accurately file confidential correspondence and documentation

Review, research and process refund requests as needed

Demonstrate knowledge of CPT, ICD 10 and procedural modifiers

Consult with supervisor, team members and appropriate resources to solve billing and collection questions and issues

Comply with the Health Insurance Portability and Accountability Act (HIPAA) in protecting patient privacy

Additional job related duties or projects as needed

COMPETENCIES

Effective communication skills

Teamwork oriented

Initiative

Proficient computer skills

Ethical conduct

Proficient typing skills

Requirements

WORK ENVIRONMENT

This position operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines.

PHYSICAL DEMANDS

The physical demands described are representative of those that must be met by an employee to successfully perform the essential functions of this job.

While performing the duties of this job, the employee is regularly to talk and listen. This is largely a sedentary role; however, there may be times of standing. Some bending, lifting of 5 to 10 lbs and routine computer usage.

POSITION TYPE AND EXPECTED HOURS

This is a full time position. Days and hours of work are Monday through Friday 8:30 a.m. to 5:30 p.m. Occasional evening and weekend work may be required as job duties demand.

TRAVEL

Some travel may be required based on the company needs and as job duties demand.

REQUIRED EDUCATION AND EXPERIENCE

High School diploma or equivalent

Two to three years of experience in the healthcare industry

PREFERRED EDUCATION AND EXPERIENCE

Medical Billing or Coding Certification

Two to three years of experience in medical billing/coding