Collector 3

Job Summary: The Collector 3 analyzes and interprets Managed Care contract language, terms, conditions and responsibility matrices. Performs telephone and written follow-up with insurance companies, third party payers, worker's compensation payers, medical groups, outside hospitals, and physician's offices to ensure timely payments for inpatient and outpatient hospital bills in accordance with the terms and conditions of each contract and/or insurance company�s policies. Ensures that payers adhere to compliance laws regarding timely processing of claims. Has expert understanding of Managed Care and insurance company payment methodologies, principles, rules, and regulations to perform reimbursement from both the third party and patient perspectives. Determines if payer needs additional information, identifies barriers, or secures payment dates. Is responsible for following through with requested information as needed in order to remove payment barriers or escalates the account to LLUH Management or Payer Management. Develops collection recovery strategies with each payer. Pursues each outstanding account to reach maximum reimbursement and closure. Trains and mentors new and existing staff. Performs other duties as needed.

Education and Experience: Minimum five year of experience in in healthcare billing, auditing, managed care or collections required; preferably in hospital billing.

Knowledge and Skills: Expert knowledge of automated billing, follow-up and adjudication systems required (LLEAP/Epic, Assurance, DDE, FISS, Medi-Cal website, and Noridian Medicare Portal). Expert knowledge of UB04, CPT, HCPC, ICD10, and EOB required. Able to 10-Key. Able to read, write legibly; speak in English with professional quality; use computer, printer, and software programs necessary to the position (e.g., Word, Excel, Outlook, PowerPoint). Operates and troubleshoots basic office equipment required for the position. Able to relate and communicate positively, effectively, and professionally with others; work calmly and respond courteously when under pressure; collaborate and accept direction. Able to communicate effectively in English in person, in writing, and on the telephone; think critically; manage multiple assignments effectively; organize and prioritize workload; work well under pressure; problem solve; recall information with accuracy; pay close attention to detail; work independently with minimal supervision. Able to distinguish colors as necessary; hear sufficiently for general conversation in person and on the telephone, and identify and distinguish various sounds associated with the workplace; see adequately to read computer screens, and written documents necessary to the position.

Licensures and Certifications: None.

 

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