Collections Specialist
Palmetto General HospitalHialeah, FL, USAjob_description.job_card.30_days_ago
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job_description.job_card.job_descriptionHigh School graduate or equivalent Minimum 1-year Commercial, HMO, PPO, and Workers Compensation billing and / or Insurance follow-up experience Working knowledge of HMO, PPO, Commercial, and Workers' Compensation reimbursement Working knowledge of Managed Care contract language and interpretation
Under the supervision of the Director of Revenue Cycle or designee, performs patient account follow-up, credit balance review and resolution, keeping the hospital's accounts receivable as accurate as possible.
Duties and Responsibilities :
- Insurance follow-up, as assigned
- Contact insurance carriers regarding outstanding balances until resolution
- Resubmit claims with the appropriate remarks and / or attachments as needed
- File insurance reconsideration letter for payment and / or denial disputes
- Validate accounts for accurate payments, discounts, and contractual adjustments
- Reply to insurance carrier correspondence as appropriate
- Run insurance eligibility and correct claim before resubmission as needed
- Pull supporting documents for annual regulatory audits, as needed
- Ensure credit balance and refund requests are reviewed and resolved timely
- Answer in-coming calls resolving patient and / or insurance issues timely
- Assist with other duties as assigned, within skill sets and abilities
Education
Experience
Location :
Westchester area / Miami, FL
Must clear background and drug test required.
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Collection Specialist • Hialeah, FL, USA