Only the job description changed.
| Previous Job Description | Current Job Description | ||||
|---|---|---|---|---|---|
| n | 1 | Job Description: | n | 1 | The Senior Collections Representative (Rep.) aka Government Sr. Follow-up Collector handles the foll |
| > | owing: | ||||
| 2 | The Senior Collections Representative (Rep.) aka Government Sr. Follow-up Collector handles the foll | 2 | * Responsible for collections, conducting proactive follow-up with payers regarding non-payments, u | ||
| > | owing: Responsible for collections, conducting proactive follow-up with payers regarding non-payment | > | nderpayments, or incorrect payments in a stratified manner. | ||
| > | s, underpayments, or incorrect payments in a stratified manner. Calculates expected reimbursement to | ||||
| > | verify expected payments versus actual payments received. Disputes with payers for denials and/or u | ||||
| > | nderpayments. Reconciles the accounts to closure. In addition, the Rep. is collector is knowledgeabl | ||||
| > | e of assigned payer claim requirements and regulations and utilizes multiple databases and applicati | ||||
| > | ons to analyze and take appropriate action on information or documents received. Applications and D | ||||
| > | atabases consist of EPIC, Hospital Rates, CIRIUS, RevCyclePro, Imaging, DDE and various payer websit | ||||
| > | es. Frequent contact with Patient Financial Services staff, departments and management, as well as p | ||||
| > | atients, billing and professional fee and collection services vendors. | ||||
| 3 | * Calculates expected reimbursement to verify expected payments versus actual payments received. | ||||
| 4 | * Disputes with payers for denials and/or underpayments. | ||||
| 5 | * Reconciles the accounts to closure. | ||||
| 3 | 6 | ||||
| t | 4 | Qualifications: | t | 7 | In addition, the Rep. is collector is knowledgeable of assigned payer claim requirements and regula |
| > | tions and utilizes multiple databases and applications to analyze and take appropriate action on inf | ||||
| > | ormation or documents received. Applications and Databases consist of EPIC, Hospital Rates, CIRIUS, | ||||
| > | RevCyclePro, Imaging, DDE and various payer websites. Frequent contact with Patient Financial Servic | ||||
| > | es staff, departments and management, as well as patients, billing and professional fee and collecti | ||||
| > | on services vendors. | ||||
| 5 | Requirements: - Minimum of two or more years of experience in a hospital billing office environment. | ||||
| > | - High school graduates or GED certificate. - Internals Applicants: Must demonstrate an in-depth un | ||||
| > | derstanding of all aspects of billing greater than an Office Assistant III. - Knowledge of contracts | ||||
| > | , insurance billing requirements, UB04 claim forms, Medicare, Medi-Cal and compliance program regula | ||||
| > | tions. - Good analytical and organizational skills, interpersonal, verbal, and written communication | ||||
| > | skills. - Knowledge of computer operation, keyboard functions, calculator, copier and fax machine o | ||||
| > | peration. - Adequate keyboard skills. - Proactive and assertive account resolution skills. - Must be | ||||
| > | a motivated individual with a positive and exceptional work ethics. - Ability to follow directions | ||||
| > | and written procedures. - Ability to balance assertiveness with compassion for the patient and other | ||||
| > | s. - Must have a thorough understanding of CPT, ICD, DRG, and HCPC codes. - Must have a thorough und | ||||
| > | erstanding of stop losses, per diems, carve outs and other contract terms and conditions. - Computer | ||||
| > | software skills (i.e. Microsoft Applications and E-mail, etc.) - The ability to work onsite in Emer | ||||
| > | yville a min. of one day a week or more when required. Preferences: - Medical terminology experience | ||||
| > | . - ICD, CPT4, HCPCS, DRG coding experience. - Understanding of HIPAA rules and regulations | ||||