billing and collections specialist

CHRISTUS Health

<div>Description 
Summary:
Provides medical collection services for TLRA collection units. Utilizes a strong background as a medical collection specialist to successfully resolve accounts placed with TLRA for collection. This involves performing collection activities related to follow-up and account resolution and includes communication with patients, clients, reimbursement vendors, and other external entities while adhering to all client, state, and federal guidelines. Patient and client satisfaction is essential. Associates in the collection units are expected to have knowledge of the overall collection work processes for both active AR and BD inventory.
Responsibilities: 
<ul><li>Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.</li><li>
Provides effective collection services, ensuring the successful recovery of accounts in accordance with client and state guidelines as well as TLRA&rsquo;s business objectives.</li><li>
Documents and updates patient account information in TLRA&rsquo;s collection software system timely and accurate to include appropriate account status.</li><li>
Handles inbound patient and/or carrier calls promptly and professionally, providing assistance and resolution to account inquiries, issues, and requests.</li><li>
Uses collection tools effectively to ensure quality recovery services and meet or exceed established goals and work standards.</li><li>
Performs research and analysis of account issues and strives to resolve problems timely and accurately.</li><li>
Ensure daily productivity standards are met.</li><li>
Promotes positive patient relations by communicating in a manner that demonstrates respect for the human dignity of patients and/or their families.</li><li>
Must have solid knowledge and utilization of desktop applications to include Word and Excel are essential.</li><li>
General hospital A/R accounts knowledge is required.</li><li>
Performs other special projects as required when assigned.</li></ul>
Collections &ndash; Insurance
<ul><li>Maintains active knowledge of all collection requirements by payors.</li><li>
Collects balance owing from third-party payers in accordance with State and Federal laws governing collections practices. Ensures that collection efforts are thorough with the overall objective being to collect outstanding balances in an ethical manner.</li><li>
Ensures quality standards are met and proper documentation regarding patient accounting records.</li><li>
Contact other departments to obtain necessary information for appeals, pending information, and any other issues that impact and/or delay claim processing.</li></ul>
Collections &ndash; Self Pay
<ul><li>Ensures that self-pay accounts are handled in a customer service-oriented manner that accomplishes the goal of collecting monies due to clients, while at the same time preserving the positive image of TLRA that exists in the community.</li><li>
Responsible for assisting patients in identifying eligible means of financial assistance or if non apply working with the patient to make acceptable payment arrangements.</li><li>
Must be an effective team member with good communication skills. Must participate in team meetings, communicate work-related ideas and concerns proactively, and assist in finding appropriate resolutions.</li></ul>
Physician Billing/Collections
<ul><li>Ensure proper reimbursement for all services and to ensure all appeals are filed timely.</li><li>
Review accounts and determine appropriate follow-up activities utilizing Six Sigma Practices.</li><li>
Identify under and overpayments and take appropriate actions to resolve accounts.</li><li>
Validate commercial insurance claims to ensure the claims are paid according to the contract.</li><li>
Direct knowledge using Meditech and CollectLogix software.</li><li>
Monitor and communicate errors generated by other groups and evaluate for trends.</li></ul>
Job Requirements: 
Education/Skills
<ul><li>High School diploma or equivalent years of experience required.
</li></ul>Experience
<ul><li>3-5 years of experience preferred.
</li><li>experience in a Customer Service call center environment with a focus on healthcare billing/collections or collection agency environment required.
</li><li>College education, previous Insurance Company claims experience and/or health care billing trade school education may be considered in lieu of formal hospital experience.
</li></ul>Licenses, Registrations, or Certifications
<ul><li>None required.</li></ul> 
Work Schedule: 
8AM - 5PM Monday-Friday
Work Type: 
Full Time</div>

Patient Account Specialist Senior - TLRA Support Services

<div>Description 
Summary:
Provides medical collection services for TLRA collection units. Utilizes a strong background as a medical collection specialist to successfully resolve accounts placed with TLRA for collection. This involves performing collection activities related to follow-up and account resolution and includes communication with patients, clients, reimbursement vendors, and other external entities while adhering to all client, state, and federal guidelines. Patient and client satisfaction is essential. Associates in the collection units are expected to have knowledge of the overall collection work processes for both active AR and BD inventory.
Responsibilities: 
<ul><li>Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.</li><li>
Provides effective collection services, ensuring the successful recovery of accounts in accordance with client and state guidelines as well as TLRA&rsquo;s business objectives.</li><li>
Documents and updates patient account information in TLRA&rsquo;s collection software system timely and accurate to include appropriate account status.</li><li>
Handles inbound patient and/or carrier calls promptly and professionally, providing assistance and resolution to account inquiries, issues, and requests.</li><li>
Uses collection tools effectively to ensure quality recovery services and meet or exceed established goals and work standards.</li><li>
Performs research and analysis of account issues and strives to resolve problems timely and accurately.</li><li>
Ensure daily productivity standards are met.</li><li>
Promotes positive patient relations by communicating in a manner that demonstrates respect for the human dignity of patients and/or their families.</li><li>
Must have solid knowledge and utilization of desktop applications to include Word and Excel are essential.</li><li>
General hospital A/R accounts knowledge is required.</li><li>
Performs other special projects as required when assigned.</li></ul>
Collections &ndash; Insurance
<ul><li>Maintains active knowledge of all collection requirements by payors.</li><li>
Collects balance owing from third-party payers in accordance with State and Federal laws governing collections practices. Ensures that collection efforts are thorough with the overall objective being to collect outstanding balances in an ethical manner.</li><li>
Ensures quality standards are met and proper documentation regarding patient accounting records.</li><li>
Contact other departments to obtain necessary information for appeals, pending information, and any other issues that impact and/or delay claim processing.</li></ul>
Collections &ndash; Self Pay
<ul><li>Ensures that self-pay accounts are handled in a customer service-oriented manner that accomplishes the goal of collecting monies due to clients, while at the same time preserving the positive image of TLRA that exists in the community.</li><li>
Responsible for assisting patients in identifying eligible means of financial assistance or if non apply working with the patient to make acceptable payment arrangements.</li><li>
Must be an effective team member with good communication skills. Must participate in team meetings, communicate work-related ideas and concerns proactively, and assist in finding appropriate resolutions.</li></ul>
Physician Billing/Collections
<ul><li>Ensure proper reimbursement for all services and to ensure all appeals are filed timely.</li><li>
Review accounts and determine appropriate follow-up activities utilizing Six Sigma Practices.</li><li>
Identify under and overpayments and take appropriate actions to resolve accounts.</li><li>
Validate commercial insurance claims to ensure the claims are paid according to the contract.</li><li>
Direct knowledge using Meditech and CollectLogix software.</li><li>
Monitor and communicate errors generated by other groups and evaluate for trends.</li></ul>
Job Requirements: 
Education/Skills
<ul><li>High School diploma or equivalent years of experience required.
</li></ul>Experience
<ul><li>3-5 years of experience preferred.
</li><li>experience in a Customer Service call center environment with a focus on healthcare billing/collections or collection agency environment required.
</li><li>College education, previous Insurance Company claims experience and/or health care billing trade school education may be considered in lieu of formal hospital experience.
</li></ul>Licenses, Registrations, or Certifications
<ul><li>None required.</li></ul> 
Work Schedule: 
5 Days - 8 Hours
Work Type: 
Full Time</div>

Patient Account Specialist Senior - TLRA Insurance

Physicians Revenue Group

Job SummaryWe are looking for an AR Specialist to manage accounts receivable activities, including claim follow-ups, payment posting review, and issue resolution, to ensure timely collections and maximum reimbursement. The candidate should have working knowledge of US medical billing and AR processes.Key Responsibilities<ul><li>Perform AR follow-ups on unpaid and underpaid insurance claims.</li><li>Review claim status, EOBs, and ERAs to identify payment issues.</li><li>Work on basic denials, rejections, and corrected claims as required.</li><li>Communicate with insurance companies via calls and payer portals.</li><li>Update claim status and maintain accurate AR records.</li><li>Ensure compliance with HIPAA and payer guidelines.</li><li>Meet assigned productivity and turnaround time targets.</li></ul>Required Skills &amp; Experience<ul><li>6 months or more experience in AR / US Medical Billing.</li><li>Basic knowledge of CPT, ICD-10, and HCPCS codes.</li><li>Experience handling EOBs, ERAs, and AR aging reports.</li><li>Familiarity with Medicare, Medicaid, and Commercial payers.</li><li>Good communication and follow-up skills.</li><li>Willingness to work in night shift (US time zone).</li></ul>Job Type: Full-timeAbility to commute/relocate:<ul><li>Lahore Johar Town: Reliably commute or planning to relocate before starting work (Preferred)</li></ul>Education:<ul><li>Middle School (Preferred)</li></ul>Experience:<ul><li>2year: 1 year (Preferred)</li></ul>Work Location: In person

AR Representative - Medical Billing

Children's Hospital Colorado

<div><h2 class="jobSectionHeader">Job Overview</h2>
<div>
<div><div><div>The Patient Financial Experience and Collections Specialist supports both inbound and outbound collections functions for Patient Financial Services, maintains and updates accounts, and conducts analyses for trending and reporting. Demonstrates the ability to appropriately maximize the resolution of all accounts by requesting payment in full, arranging payment schedules, or discovering other insurance. This position possesses good investigatory skills, is detail-oriented, exhibits good listening and problem-solving skills, and can speak with patients/families who may be under tress due to unpaid debts. Helps in educating families on their bill and work to solve concerns presented by patients/families, including collaborating with other internal teams and payers to work accounts to resolution.
Additional Information 
Department Name: Patient Financial Services 
Job Status: Full time, 40 hours per week. 
Shift: Day, 8am to 4:30pm, Hybrid 
 
Duties &amp; Responsibilities<ul><li>
Accepts incoming calls and conducts outbound calls patients/families with outstanding balances to review account information, examine eligibility for financial assistance, and secure payment arrangements. Calculates remaining balances, and then discusses and finalizes the method of resolving balances providing options to patients/families to pay their account balances.</li><li>
Maintains knowledge of requirements and guidelines for hospital-sponsored charity care, as well as the availability of financial assistance from external sources.</li><li>
Performs billing and follow-up functions on assigned accounts to resolve billing, payment and contractual issues in a manner that conforms to all federal, state and payer regulations and that elicits accurate and timely reimbursement from payers and families.</li><li>
Provides excellent customer service to all stakeholders, internal and external. Responds to all phone calls (both inbound and outbound) in an efficient and courteous manner. Listens and responds to customer service needs with the appropriate level of urgency.</li><li>
Maintains knowledge of insurance plans and has knowledge of reading and explaining insurance benefits, including the explanation of benefits and cost sharing portions (co-pay, deductible, coinsurance) due by patients/families per their insurance plan processing.</li><li>
Coordinates with both internal teams and payers to resolve accounts, including submitting for reprocessing or updates to ensure accounts accurately reflect patient/families responsibilities.</li><li>
Diffuses escalated calls, working with patients/families to understand their bill, providing exceptional customer service, coordinating with internal and external stakeholders to help resolve concerns providing a one-stop shop experience which may require follow up to the patient/family if not able to be solved on initial call.</li><li>
Updates insurance coverage as necessary to ensure accounts are processed appropriately.</li><li>
Responds to both individual and centralized PFS e-mails, responding professionally with the understanding of responding on behalf of CHCO to financial questions from patients/families, attorneys, payers, etc.</li></ul>
Minimum Qualifications<ul><li>
Degrees<ul><li>
High School diploma or GED</li></ul></li><li>
Area of Study<ul><li>
Not Applicable.</li></ul></li><li>
Experience<ul><li>
Minimum Experience. Required:One (1) year of experience in collections or call center within a healthcare, front-line clinic, billing office and/or admissions department setting.</li></ul></li><li>
Equivalency<ul><li>
Not Applicable</li></ul></li><li>
Licenses &amp; Certifications<ul><li>
None</li></ul></li><li>
Additional Requirements<ul><li>
Not Applicable.</li></ul></li><li>
Competency<ul><li>
None</li></ul></li></ul> 
Salary Information 
Pay is dependent on applicant's relevant experience. 
 
Hourly Range: $20.14 to $30.21 
 
Benefits Information 
Here, you matter. As a Children&rsquo;s Hospital Colorado team member, you will receive a competitive pay and benefits package designed to take care of your needs that includes base pay, incentives, paid time off, medical/dental/vision insurance, company provided life and disability insurance, paid parental leave, 403b employer match (retirement savings), a robust wellness program, and access to professional development tools, including an education benefit to help you advance your career.
As part of our Total Rewards package, Children's Colorado offers an annual employee bonus program that rewards eligible team members based on organizational performance. If organizational goals are met for the year, the bonus is paid out the following April.
Children&rsquo;s Colorado delivers annual base pay increases to eligible team members based on their performance over the previous year. 
 
EEO Statement 
It is our intention that all qualified applicants be given equal opportunity and that selection decisions be based on job-related factors. We do not discriminate on the basis of race, color, religion, national origin, sex, age, disability, or any other status protected by law or regulation. Be aware that none of the questions are intended to imply illegal preferences or discrimination based on non-job-related information. The position is expected to stay open until the posted close date. Please submit your application as soon as possible as the posting is subject to close at any time once a sufficient pool of qualified applicants is obtained. 
 
Colorado Residents: In any materials you submit, you may redact or remove age-identifying information such as age, date of birth, or dates of attendance at or graduation from an educational institution. You will not be penalized for redacting or removing this information.</div></div></div></div></div>

Patient Financial Experience and Collections Specialist

PruittHealth

JOB PURPOSE: 
Manage the Private Billing and AR collections processes for a group of Healthcare Centers through American Health Tech’s Long Term Care (LTC) software program. Successful individuals are able to manage a reasonable volume of detailed work, are familiar with the rules and regulations of Private billing and are skilled at problem solving and account resolution. This position will work under general supervision. This position will function within a team environment. Successful individuals will be able to work well with other team members to meet or exceed financial goals set by the organization.
 
ESSENTIAL JOB FUNCTIONS, DUTIES, AND RESPONSIBILITIES: 
<ul>
<li>Prepare and transmit Georgia Private Billing claims.</li>
<li>Research, correct and re-bill outstanding Private Billing claims.</li>
<li>Responsible for Private Billing Collections and Days Sales Outstanding.</li>
<li>Work with the healthcare center administrator and office personnel to manage the facility’s Private Billing accounts receivable.</li>
<li>Respond to change productively and handle additional projects as assigned.</li>
<li>Carry out all duties with a “Commitment to Caring” attitude in accordance with the company’s mission, vision, and philosophy.</li>
<li>Follow all company policies and procedures, state and federal laws and regulations and report violations to the appropriate supervisor.</li>
<li>File and organize all appropriate paperwork related to job duties.</li>
</ul>
LICENSURE, CERTIFICATION, EXPERIENCE AND EDUCATION REQUIREMENTS:
 <ul>
<li>1-3 years’ experience with Georgia or South Carolina Private billing and collections.</li>
<li>Previous experience with LTC-Long Term Care a plus.</li>
<li>Excellent communication and organizational skills.</li>
<li>Proficient with the Microsoft Office Suite.</li>
<li>Experience with LTC and/or Healthcare is valuable.</li>
</ul>
Family Makes Us Stronger. Our family, your family, one family. Committed to loving, giving, and caring. United in making a difference.
 We are eager to connect with you! Apply Now to get started at PruittHealth!
 As an Equal Employment Opportunity employer, all qualified applicants will receive consideration without regard to race, color, religion, sex, national origin, disability, or veteran status.
 
For Florida Job Postings Only: 
For more information regarding Florida’s Care Provider Background Screening Clearinghouse Education and Awareness, please visit https://info.flclearinghouse.com

Private Billing Specialist

Concentra

Overview: Are you looking for a career that transcends the ordinary? At Concentra, we offer opportunities beyond patient care. As a valued member of our team, you'll be part of our efforts to provide exceptional service to our employer clients and exceptional care to their employees. Our values define our path forward &ndash; always working to ensure welcoming, respectful, and skillful care. Join Concentra, and see what makes us different and better. The Central Billing Office (CBO) Reconsideration Specialist performs a variety of basic tasks to moderately complex tasks to effectively process various billing adjustments and reconsideration payments according to Concentra and Central Billing Office policies and procedures. Responsibilities: Communicates improper payments from payors Identifies and monitors incorrect reimbursement issues Identifies and applies appropriate adjustments per contracts or state requirements Processes and monitors all reconsiderations ensuring processing with the appropriate state reports, transcription, and explanation of benefits Follows-up on all previously sent reconsiderations for proper payment Processes short/zero payments for reconsiderations Applies proper adjustments Communicates with CBO supervisor/manager regarding issues and resolution Performs other duties as assigned This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice. Qualifications: Education Level: High School Diploma or GED Major: Degree must be from an accredited college or university. Job-Related Experience 1- 3 years&rsquo; experience in medical billing or collections Job-Related Skills/Competencies Concentra Core Competencies of Service Mentality, Attention to Detail, Sense of Urgency, Initiative and Flexibility Ability to make decisions or solve problems by using logic to identify key facts, explore alternatives, and propose quality solutions Outstanding customer service skills as well as the ability to deal with people in a manner which shows tact and professionalism The ability to properly handle sensitive and confidential information (including HIPAA and PHI) in accordance with federal and state laws and company policies Strong computer skills Working knowledge of medical CPT/ICD-9 coding Strong problem-solving skills Strong communication skills Strong organizational skills Ability to work in fast-paced environment Strong attention to detail Ability to research workers compensation and coding rules Clear understanding of workers compensation reimbursement guidelines and regulations Ability to work independently Strong customer service skills Ability to assist peers and train new colleagues Additional Data: Employee Benefits 401(k) Retirement Plan with Employer Match Medical, Vision, Prescription, Telehealth, &amp; Dental Plans Life &amp; Disability Insurance Paid Time Off &amp; Extended Illness Days Offered Colleague Referral Bonus Program Tuition Reimbursement Commuter Benefits Dependent Care Spending Account Employee Discounts This job requires access to confidential and critical information, requiring ongoing discretion and secure information management. We will ensure that individuals with disabilities are provided reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. Please contact us to request accommodation. Concentra is an Equal Opportunity Employer, including disability/veterans Concentra is an equal opportunity employer that prohibits discrimination, and will make decisions regarding employment opportunities, including hiring, promotion and advancement, without regard to the following characteristics: race, color, national origin, religious beliefs, sex (including pregnancy), age, disability, sexual orientation, gender identity, citizenship status, military status, marital status, genetic information, or any other basis protected by federal, state or local fair employment practice laws.

Reconsideration Specialist

VieMed, LLC

<div>Duties:
<div><ul><li>Review and understand Insurance policies and standard Explanation of Benefits.</li></ul>
<ul><li>Review and understand medical documentation effectively</li></ul>
<ul><li>Review and resolve Back Collections related tasks, such as
<div><ul><li>Denial appeals</li></ul>
<ul><li>Payment review and balance billing</li></ul>
<ul><li>Claims generation</li></ul>
</div></li></ul><ul><li>Establishes and maintains effective communication and good working relationships with insurance carriers, patients/family, and other internal teams for the patient&rsquo;s benefit.</li></ul>
<ul><li>Performs other clerical tasks as needed, such as
<div><ul><li>Answering patient/Insurance calls</li></ul>
<ul><li>Faxing and Emails</li></ul>
</div></li></ul><ul><li>Communicates appropriately and clearly to Manager/Supervisor, and other superiors. Reports all concerns or issues directly to Revenue Cycle Manager and Supervisor</li></ul>
<ul><li>Other responsibilities and projects as assigned.</li></ul></div> 


Requirements:
<ul><li>High School Diploma or equivalent</li>
<li>Knowledge of Explanation of Benefits from insurance companies</li>
<li>General knowledge of government, regulatory billing and compliance regulations/policies for Medicare &amp; Medicaid</li>
<li>Working knowledge of CPT and ICD-10 codes, HCFA 1500, UB04 claim forms, HIPAA, billing and insurance regulations, medical terminology, insurance benefits.</li>
<li>Enough knowledge of policies and procedures to accurately answer questions from internal and external customers.</li>
<li>Utilizes initiative while maintaining set levels of productivity with consistent accuracy.</li></ul> 


Experience:
<ul>
<li>3-5 Years in DME or medical billing experience preferred.</li>
<li>Minimum of 1 year of insurance verification or authorizations required.</li></ul> 


Skills:
<ul>
<li>Superior organizational skills.</li>
<li>Proficient in Microsoft Office, including Outlook, Word, and Excel.</li>
<li>Attention to detail and accuracy.</li>
<li>Effective/professional communication skills (written and oral)</li></ul></div>

Claims Resolution Specialist

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