Medical Collector – PB

• Complete daily follow-up or denial account assignments accurately and timely
• Identify and analyze underpayments, discrepancies, denials, and appeals
• Review posted payments and adjustments for accuracy
• Analyze EOBs to ensure proper reimbursement
• Research, document, track, respond to, and resolve appeals with third-party payers
• Communicate with payers regarding outstanding claims and payment variances
• Document all activity on patient accounts
• Collaborate with internal departments and external organizations to resolve reimbursement and appeals issues
• Monitor underpaid and denied claims for trends and root causes; report findings to the supervisor
• Recommend improvements and communicate trends and issues to management
• Follow best-practice processes in follow-up and customer service
• Participate in staff training related to Medicare/Medicaid requirements and follow-up processes
• Act in accordance with LCMC Health's mission and values and model ethical behavior
• Adhere to federal and state patient-information protection regulations and facility guidelines

• Minimum two years of experience in a healthcare environment, particularly healthcare billing, collections, payment processing, or denial management is preferred
• High school diploma or GED required
• Must pass a basic computer skills test and system-level training
• Working knowledge of system reports and ability to analyze system information
• Knowledge of hospital and professional billing processes and reimbursement
• Knowledge of third-party contracting
• Knowledge of insurance protocols, delay tactics, systems, and workflows
• Knowledge of ERISA guidelines for denials and appeals
• Knowledge of regulations related to denials and appeals
• Ability to identify problems, conceptualize resolutions, and implement change
• Efficient time-management skills and ability to multitask under tight deadlines
• Excellent customer service skills
• Effective writing and communication skills
• Strong comfort level with computer systems
• Proof of citizenship or immigration status required to verify lawful right to work in the United States

Demonstrates expertise in healthcare billing processes, denial management, and appeals resolution, with a strong focus on compliance with regulations and effective communication with payers. Proven ability to analyze discrepancies and implement improvements in reimbursement practices.

• Healthcare Billing
• Denial Management
• Appeals Resolution
• Customer Service
• Time Management

• Payment Processing
• EOB Analysis
• Insurance Protocols
• Regulatory Compliance
• System Reporting
• Problem Identification
• Change Implementation
• Multitasking
• Data Documentation
• Reimbursement Knowledge

• Effective Communication
• Customer Service Skills

• High School Diploma
• GED

• Medicare
• Medicaid
• ERISA Guidelines
• Third-Party Contracting
• Patient Information Protection

• Computer Systems
• Billing Software