Only the job description changed.
| Previous Job Description | Current Job Description | ||||
|---|---|---|---|---|---|
| t | 1 | Job Description: | t | 1 | Sr. Collections Representative Lead Representative (Lead) . The Lead is assigned job functions that |
| > | parallel that of a *Biller/Collector. The Lead has advanced knowledge of Government payer billing an | ||||
| > | d collections and serves as a resource person to other staff members and management. The Lead is res | ||||
| > | ponsible for assisting with training, monitoring backlogs and are assigned special projects. The Lea | ||||
| > | d is responsible for both billing and collections, gathering and securing all information needed for | ||||
| > | billing, follow up, and payment of accounts in accordance with the specific payer guidelines, polic | ||||
| > | ies, procedures, and compliance regulations. *A Biller/Collector is responsible for the following: | ||||
| 2 | Sr. Collections Representative Lead Representative (Lead) . The Lead is assigned job functions that | 2 | Reviewing, correcting, and completing billings to ensure complete and accurate billing of Medicare, | ||
| > | parallel that of a *Biller/Collector. The Lead has advanced knowledge of Government payer billing a | > | Medi-Cal and/or Managed Medicare/Medi-Cal payers; calculates expected reimbursement to verify expect | ||
| > | nd collections and serves as a resource person to other staff members and management. The Lead is r | > | ed payments versus actual payments received; files disputes with payers for denials and/or underpaym | ||
| > | esponsible for assisting with training, monitoring backlogs and are assigned special projects. The | > | ents; and is accountable and responsible for accurate billing and reconciles accounts to closure. Th | ||
| > | Lead is responsible for both billing and collections, gathering and securing all information needed | > | e Lead utilize multiple databases and applications to analyze and take appropriate action on informa | ||
| > | for billing, follow up, and payment of accounts in accordance with the specific payer guidelines, po | > | tion or documents received. Applications and Databases consist of EPIC, Hospital Rates, CIRIUS, RevC | ||
| > | licies, procedures, and compliance regulations. *A Biller/Collector is responsible for the followin | > | yclePro, Imaging, DDE and various payer websites. Frequent contact with Patient Financial Services s | ||
| > | g: Reviewing, correcting, and completing billings to ensure complete and accurate billing of Medicar | > | taff, departments and management, as well as patients, billing and professional fee and collection s | ||
| > | e, Medi-Cal and/or Managed Medicare/Medi-Cal payers; calculates expected reimbursement to verify ex | > | ervices vendors. | ||
| > | pected payments versus actual payments received; files disputes with payers for denials and/or unde | ||||
| > | rpayments; and is accountable and responsible for accurate billing and reconciles accounts to closur | ||||
| > | e. The Lead utilize multiple databases and applications to analyze and take appropriate action on i | ||||
| > | nformation or documents received. Applications and Databases consist of EPIC, Hospital Rates, CIRIUS | ||||
| > | , RevCyclePro, Imaging, DDE and various payer websites. Frequent contact with Patient Financial Ser | ||||
| > | vices staff, departments and management, as well as patients, billing and professional fee and colle | ||||
| > | ction services vendors. | ||||
| 3 | |||||
| 4 | Qualifications: | ||||
| 5 | Requirements: - High school graduates or GED certificate. - Four or more years of experience in a ho | ||||
| > | spital billing office environment. - Knowledge of contracts, insurance billing requirements, UB04 cl | ||||
| > | aim forms, Medicare, Medi-Cal and compliance program regulations. - Good analytical and organization | ||||
| > | al skills, interpersonal, verbal, and written communication skills. - Knowledge of computer operatio | ||||
| > | n, keyboard functions, calculator, copier and fax machine operation. - Adequate keyboard skills. - P | ||||
| > | roactive and assertive account resolution skills. - Must be a motivated individual with positive and | ||||
| > | exceptional work ethics. - Ability to follow directions and written procedures. - Ability to balanc | ||||
| > | e assertiveness with compassion for the patient and others. - Must have a thorough understanding of | ||||
| > | CPT, ICD, DRG, and HCPC codes. - Must have a thorough understanding of stop losses, per diems, carve | ||||
| > | -outs and other contract terms and conditions. - Computer software skills (i.e. Microsoft Applicatio | ||||
| > | ns and E-mail, etc.) - Must demonstrate an in-depth understanding of all aspects of billing greater | ||||
| > | than an Office Assistant III and Senior Collections Rep I. Note: This requirement applies only to UC | ||||
| > | SF Internals applicants only. Preferred Qualifications - Medical terminology experience. - ICD, CPT4 | ||||
| > | , HCPCS, DRG coding experience. - Understanding of HIPAA rules and regulations. | ||||