The Collection Specialist uses system collection reports, such as: aged trial balances, data search reports, and Epic work queues to identify unpaid claims for collection/appeals.
Specific Duties & Responsibilities
Uses system collection reports, such as: aged trial balances, data search reports, and Epic work queues to identify unpaid claims for collection/appeals. Communicates with third-party payers, patients, physicians, and other parties to resolve unpaid claims. Reviews and updates patient registration information (demographic and insurance) in Epic as needed. Utilizes follow up work queues to process A/R and works to completion. Applies appropriate discounts/courtesies based on department policy. Prints and mails claim forms and statements according to the follow-up matrix. Works in Epic Claim work queues, as well as Availity to process claim-related edits. Retrieves supporting documents (medical reports, authorizations, etc.). as needed and submits to third-party payers. Identifies and informs the Supervisor/Production Unit Manager of issues or problems associated with non-payment of claims. Appeals rejected claims and claims with low reimbursement. Identifies and informs management of systems or operational issues affecting collections, reimbursement and/or day in accounts receivable. Processes third-party payer correspondence for resolution and/or payment of claims. Researches and resolve Production Unit posting errors during the month.
Minimum Qualifications (Required)
High School Diploma/GED.
One (1) year experience in a medical billing or similar medical specialty environment required.
Additional education may substitute for required experience to the extent permitted by the * JHU Equivalency Formula: 30 undergraduate degree credits (semester hours) or 18 graduate degree credits may substitute for one year of experience. 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. *
Special Knowledge, Skills, and Abilities
Knowledge of medical terminology, CPT codes and diagnosis coding required.
Excellent interpersonal, communication and customer service skills required.
Ability to use various billing and patient information computer systems preferred.
Knowledge of various payer processing and submission guidelines preferred.
Able to operate basic office equipment, e.g. photo copier, fax machine, scanner, PC, telephone, etc.
Classified Title: Collection Specialist Working Title: CO Collection Specialist Role/Level/Range: ATO 40/E/02/OC Starting Hourly Pay Rate Range: $13.36 - $18.41 /Commensurate with Experience Employee group: Full Time Schedule: Monday - Friday, 8:00a - 5:00p/ 40 hrs per week Exempt Status: Non-Exempt Location: 16-MD:JH at White Marsh Department name: 10003198-SOM Sur Production Unit Billing 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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