Job Title: MANAGED CARE/COMMERCIAL COLLECTOR

Job Summary: Responsible for collecting on assigned accounts in a professional and timely manner. Works with Insurance companies and other payors to resolve accounts efficiently. Must be able to multi-task and have knowledge of contract language.

Each day is a fresh opportunity to impact the lives of our patients, families, co-workers, and communities. We promote excellence, optimism, respect, and professional growth. If you are looking for a rewarding and positive workplace, look no further than in your own community!

Reports To: Managed Care/Commercial Manager, and or Revenue Cycle Director/Manager

Essential Job Duties:

• Demonstrates competency in the quality of work and knowledge of the job pertinent to the functioning of the position of Collector.

• Follows up on all accounts after billing until payment is received.

• Reviews and follows up on aged accounts with documentation in an efficient and thorough manner with accuracy.

• Ensures appropriate phone calls/or website status towards resolution on each account.

• Ensures re-bills to payors as needed and change update to correct plan IDs.

• Prepares appeals on denials and underpayments.

• Mails follow-up letters to patients/ insurance companies as needed.

• Consistently exercises sound judgment in arranging account settlement plans.

• Prepares accounts settlement options in a clear and persuasive manner.

• Works accounts on work ques/reports provided, averaging a minimum of 45-55 per day.

• Handles all clients in a courteous and professional manner.

• Ensures contractual/discounts are applied to accounts as specified in each contract.

• Refers an account to a biller and forwards a copy of the primary carrier’s EOB if a secondary insurance is applicable.

• Follows up on all correspondence requiring action as needed.

• Retrieves Patient records from the HBF system as needed.

• Demonstrates the ability to recognize and deal with priorities in order to complete work in a timely manner.

• Performs all other duties and projects as assigned.

Behavioral Standards:

• Exhibits customer and service-oriented behaviors in everyday work interactions.

• Demonstrates a courteous and respectful attitude to internal workforce and external customers.

• Communicates accurately and appropriately.

• Works well and efficiently under minimal supervision.

• Handles difficult situations in a discreet and professional manner.

• Is adaptable to changes in assignments and priorities.

Communication/Knowledge:

• Provides accurate and timely written and verbal communication of information in a manner that is understood by all.

• Able to listen, understand, problem-solve, and carry-out duties to ensure the optimal outcome.

• Able to use IT systems in an accurate and proficient manner.

Collaboration/Teamwork:

• Contributes toward effective, positive working relationships with internal and external colleagues.

• Demonstrates cooperation, flexibility, reliability, and dependability in all daily work activities and a willingness to collaborate with others for the good of the customer and the organization.

Education/Experience:

• High school graduate or equivalent required

• Prefer at least 2 to 3 years of current experience in an acute care hospital setting

• Knowledge of contracts

• Computer skills preferred

Licensure/Certifications:

• N/A

ADA/Physical Demands:

ADA CONSIDERATION: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Such accommodations must be requested by the employee/applicant in order to be considered.

LANGUAGE SKILLS: Must be able to read, analyze, and interpret common scientific and technical information, and to be easily understood through verbal communication in the English language. Must be able to prepare documentation in a manner that conforms to prescribed style and format, and to respond to common inquiries or complaints from customers, regulatory agencies, or members of the business community. Bilingual skills (Spanish) preferred.

MATHEMATICAL SKILLS: Must be able to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to perform these operations using units of weight measurement, volume, and distance. Ability to perform upper level mathematical operations, including algebra and geometry, frequent distribution, determination of test reliability and validity, analysis of variance, correlation techniques, sampling theory and factor analysis.

PHYSICAL DEMANDS: Is occasionally required to stand; walk; sit; use hands to finger, handle, or feel; reach with hands and arms; stoop, kneel, crouch, or crawl; talk or hear; and taste or smell. The employee is regularly required to lift, push and/or pull weights in excess of 10 pounds. The employee must occasionally lift and/or move more than 100 pounds, with assistance. Specific vision abilities required by this job include close vision, color vision, peripheral vision, depth perception, and ability to adjust focus.

WORK ENVIRONMENT: Is occasionally exposed to toxic or caustic chemicals, risk of electrical shock, and vibration. The noise level in the work environment is usually moderate.