Medical Collections Representative

Summary: The Medical Collections Representative is responsible for ensuring timely and accurate payment of healthcare claims. This includes resolving claims denials, processing payments, working refunds, patient collections, adjusting and monitoring accounts receivables with the goal of bringing the account to a zero balance.

Schedule: Monday-Friday 8a-5pm

• Background check will be performed with an offer of employment.
• *FOR INTERNAL CANDIDATES - SEE BELOW

Responsibilities

• Follow up on outstanding claims and resolve claim denials.
• Patient Collections on unpaid balances to include establishing payment plans and Payment Assurance.
• A/R Projects as assigned.
• Process payments and adjustments.
• Prepare patient refunds.
• Communicate with insurance companies and patients.
• Review and maintain AR within pre-set policies and goals.
• Update patient demographics including new insurances as needed.
• Answer patient inquiries.
• Identify and resolve patient billing complaints and questions.
• Prepare, review and send patient statements weekly.
• Maintain strict confidentiality, adhere to HIPAA guidelines and regulations.
• Update the patient account record to identify actions taken on the account in a timely manner.
• Other duties as assigned.