Medical collector job description

Forefront Telecare Inc. (an Access Telecare company) provides telehealth behavioral health services for patients in the acute and post-acute settings, including hospitals, skilled nursing facilities and home settings with an emphasis on serving the senior population. Our mission is to provide quality behavioral health telehealth services that are widely accessible to patients in all 50 states.
We are seeking an Accounts Receivable Representative. This role is fully remote!

JOB DESCRIPTION

Accounts Receivable Representative will ensure a timely collection of outstanding behavioral health accounts receivables and resolve denials/billing issues of submitted claims. These receivables will consist of Medicare, Medicaid and commercial payor accounts.

ESSENTIAL DUTIES

+ Perform accounts receivable aging reviews and prioritize collection efforts based on aging and balance

+ Review insurance payments for accuracy and compliance with contracts.

+ Responsible for resolving claims with insurance carriers and being aware of issues/denials that impact collections.

+ Identifying and correcting billing errors and resubmitting claims to insurance carrier

+ Follow up with insurance denials, appeals, and resubmissions

+ Submit adjustment/write off requests for charges deemed uncollectible under company policy

+ Recognize and communicate trends or problems to management

+ Coordinate activities with other departments for effective collection outcomes

REQUIREMENTS AND QUALIFICATIONS

+ Must have Medicare, Medicaid, and Commercial collections experience

+ Must have an understanding of HCFC1500 claim forms

+ Knowledge of insurance, especially Medicare and Medicaid, rules and guidelines.

+ Strong knowledge and implementation of appeals process

+ Strong analysis of EOBs for collections purposes

+ Extremely detail oriented when working on appeals or reviewing EOBs

+ Proficient use of Microsoft Windows and Microsoft Office

+ Ability to resolved issues and/or inquiries in a timely manner

+ Knowledge of ICD-10 and CPT coding

+ Minimum of 2 years' experience in medical collection/billing, Behavioral Health preferred, but not required

+ Experience in A/R analysis, account auditing, and EOB analysis is mandatory

+ Excellent interpersonal skills

+ Strong verbal and organizational skills

Forefront Telecare is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status. Forefront Telecare is an E-Verify company.

• Makes calls to insurance companies regarding proper address of claims and eligibility, claim status and related claim issues as needed.
• Answer billing, insurance, and aid program questions and understand account balances.
• Generates and submits secondary paper claims and primary electronic claims as needed with follow up at designated intervals; corrects any errors for complete and accurate transmission of data.
• Applies patient payments, insurance payments and copays as instructed.
• Audits and corrects demographics as needed.
• Maintains an up to date billing manual for reference and/or is familiar with where to locate information on the internet.
• Makes calls to and receives calls from patients as needed regarding billing and statement questions.
• Calls insurance carriers to check status of claims.
• Accurately uses ICD9, CPT, and HCPCS coding.
• Keeps Accounts Receivable to 45 days by working Aging and timely follow-up of unpaid claims and working claim denials.
• Identifies and resolves billing and claim queries/problems.
• Performs any work as described above in an independent, responsible manner.
• Assists Patient Financial Services Manager in training new collections staff.
• Helps cover Medical Biller position as needed for coverage for vacations and illness as assigned by Patient Financial Services Manager.
• Participates in ongoing training.
• Other duties as assigned.

Qualifications

Education:

• High school diploma or equivalent.

Experience:

• Experience with eCW preferred.
• Insurance billing experience preferred.

Knowledge and Skills:

• Knowledge of medical billing and collections terminology.
• Must take initiative and work in an independent fashion.
• Ability to perform diversified clerical functions and basic accounting procedures.
• Ability to effectively communicate with people at all levels and from various backgrounds.
• Commitment to excellence and high standards.
• Strong organizational, problem-solving and analytical skills.
• Acute attention to detail.
• Versatility, flexibility, and a willingness to work within constantly changing priorities with enthusiasm.
• Knowledge of claim follow-up for Medicare, Medi-Cal, CDP, Family Pact, private insurance, CHDP and more.
• Ability to make status calls to facilitate claim payment.
• Ability to make calls to patient to facilitate payment plans on aged accounts.
• Able to meet aggressive collection goals.
• Ability to successfully handle claim denials.
• Demonstrated outstanding customer service.
• Ability to work independently and as a member of the collections team.
• Fluency in English and Spanish (speak, read and write) preferred.
• Ability to work a flexible schedule.
• Demonstrates knowledge of compliance issues within the community clinic environment.
• Demonstrates a willingness to report any incident that is unusual or incompatible with accepted clinic procedures.
• Maintains confidentiality of patients at all times by complying with HIPAA policies.
• Strong interpersonal skills; ability to be sensitive with persons of various social, cultural, economic and educational backgrounds.
• Proficiency with Microsoft Office applications including Outlook, Word, Excel and PowerPoint.
• Strong organizational skills with ability to prioritize projects, work relatively independently, manage multiple tasks, and meet deadlines.
• Strong written and verbal communication skills.
• Good judgment, problem solving and decision-making skills.

Physical Requirements:

While performing the duties of this job, this position is frequently required to do the following:

• Bending
• Lifting
• Extended sitting at computer
• Use standard office equipment and access, input, and retrieve information from a computer. Use computer keyboard with manual and finger dexterity and wrist-finger speed sufficient to perform repetitive actions efficiently for extended periods of time.
• Communicate effectively in person or via telephone in a manner, which can be understood by those with whom the person is speaking, including a diverse population.
• Give and follow verbal and written instructions with attention to detail and accuracy.
• Perform complex mental functions; collect, interpret, and/or analyze complex data and information.
• Vision: see details of objects at close range.
• Coordinate multiple tasks simultaneously.
• Reach forward, up, down, and to the side
• Sit or stand for minimum periods of one hour at a time and come and go from the work area repeatedly throughout the day.
• Lift up to 20 pounds.