Account Resolution Insurance Collector

Description

Shift: Days

Job Summary: Under the direction of the Account Resolution Supervisor and the Director of Patient Financial Services, the Account Resolution Insurance Collector position is responsible for management of accounts so that accounts receivable is minimized. Job duties include but are not limited to ensuring that claims are processed accurately and efficiently so that maximum hospital reimbursement is received from payers; works all denials in a timely manner according to insurance filing guidelines;

escalates any account that needs a first level appeal or has had more than 2 denials on the same claim to the Account Specialist; queues claim and provides all documents to the Account Resolution Billers on accounts that needs to be refiled to any payer; works all mail correspondence daily; assisting customers in person or by telephone to resolve issues and questions associated with their account balances;

and assisting supervisor in developing, establishing and implementing operational policies and procedures.

• Commits to one hundred percent (100%) patient and customer satisfaction by always exhibiting a courteous and helpful manner during interactions with others, including patients, families, visitors, physicians and co-workers.
• Maintains a general, overall working knowledge of the department’s mission thereby having the ability to provide basic service and support to others, including patients, families, visitors, physicians and co-workers. Recognizes when others are in need of assistance and consistently offers to help when own workload permits.
• Fully knowledgeable of the comprehensive revenue cycle policies and procedural flow, and able to apply this knowledge to all situations.

• Monitors accounts via system reminders and various reports to ensure that accounts are processed and followed-up in an accurate and timely manner so that maximum hospital reimbursement is received from payers. Works with both internal and external sources through written and oral communication to resolve any issues associated with reimbursement delays and unprocessed claims. Documents all communication and activities on account appropriately to ensure that account history is maintained.
• Responds to patient questions, inquiries and complaints as needed and documents information on account to ensure that account history is maintained.
• Secures and witnesses all required signatures according to internal policy and regulation as applicable including Release of Information, Financial Assistance Application, Financial Agreement and other attestations as applicable; appropriately documents all activities to account to ensure that account history is maintained.
• Ensures that all account balances are paid within the guidelines set forth in the JCMH collection policy; appropriately documents all activities on account to ensure that account history is maintained; communicates with both internal and external parties to ensure that they have been notified of payments, changes or issues regarding accounts.
• Maintains knowledge of assigned insurance requirements to ensure Jackson County Memorial Hospital does not take unnecessary losses or cause the patient to pay unnecessary penalties; reviews online and paper-based insurance and legal resources to ensure that receipts, adjustments and refunds are applied correctly; interacts with external and internal resources using oral and written correspondence to resolve problems.
• Maintains overall working knowledge of the Meditech B/AR and LSS module and Change Healthcare application to ensure Account Resolution area processes are completed in the most efficient manner.
• Creates, prepares and implements electronic procedure manual to ensure that the most efficient and productive methods are being used.
• Provides backup support and training to Account Resolution Biller position and other Revenue Cycle departments regarding the Account Resolution processes ensuring that daily tasks are performed accurately and efficiently.
• Prepares Account Resolution area reports on a daily,…