Collector

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Job Description Summary:

Description:

Job Summary:

Ensures the collection of patient delinquent accounts are managed in a timely and tactful manner. Reviews all outstanding insurance and self-pay balances in their assigned work-files to determine the necessary action to take in order to have the claim fully processed and paid. Reviews the denials on a daily basis to ensure claims will be timely processed. Offers support of the PPG medical practices by identifying trends that cause errors, denials and decrease in reimbursement.

Qualifications
High School Diploma or GED (Required)

Work Experience
2 - 3 years collections & nbsp; (Required)
1 - 2 years healthcare collections & nbsp; (Required)

Licenses and Certifications
Preferred Certifications/Licensures:
Certified Patient Account Representative (CPAR)

Essential Functions
COLLECTION SKILLSET:
Stays current on billing requirements for all insurances carriers.
Reviews all Medicare bulletins for changes to billing procedures.
Reviews all Medicaid regulation updates for changes to billing procedures.
Excellent knowledge of CPT Codes and ICD-9 (ICD-10) codes.
Knowledge of CMS and HIPAA regulations.
Must successfully complete the Certified Patient Account Representative (CPAR) certification offered by the Healthcare Financial Management Association (HMFA) within 20 months of hire.
Extensive knowledge of GA Collections laws.

COLLECTION TASKS:
Collectors will manage their work-file so cash flow of PPG centers will not be compromised.
Collectors will review, on a daily basis, the denial accounts that have dropped in their work file and take the necessary steps to get the claim filed appropriately.
Collects on patients' accounts that are delinquent according to established policies and procedures.
Enters information in the Notes and Comments section of the Practice Plus system, so that anyone following the account activity will readily understand the occurrences.
Maintains established system for accounts to be referred to bad debt or indigent status.
Communicates with Collection Coordinator and clinic practice managers regarding trends in errors of claims filed.

Additional Duties
Adheres to the hospital and departmental attendance and punctuality guidelines.
Performs all job responsibilities in alignment with the core values, mission and vision of the organization.
Performs other duties as required and completes all job functions as per departmental policies and procedures.
Maintains current knowledge in present areas of responsibility (i.e., self education, attends ongoing educational programs).
Attends staff meetings and completes mandatory in-services and requirements and competency evaluations on time.
Demonstrates competency at all levels in providing care to all patients based on age, sex, weight, and demonstrated needs. For non-clinical areas, has attended training and demonstrates usage of age- specific customer service skills.
Wears protective clothing and equipment as appropriate.