Specialty Collector Healthcare

Position Responsibilities Responsible for training all new hires in the EPIC system and collection department directives. Conducts review of new hire progress, audits their work for accuracy, content, and effectiveness for the initial three months. Provides the manager and team leader with new hire progress, and identifies areas requiring additional training. Acts as a Collection Team resource for questions, account assessment, payer trends and/or claim resolution as needed. Responsible for learning EPIC Physician Billing system in order to successfully complete work assignments. Prioritizes work tasks to maximize productivity and efficiency in an ongoing basis while maintaining accuracy. Responsible for working claims workques in order to resolve claim issues and identifying denied claims requiring the submission of appeals. Responsible for tracking submitted appeals for status and resolution. (Both 1st and 2nd level appeals), and conducting follow up on deferred claims for resolution. Maintains clear and concise documentation of all collection activity on each patient accounts. Must include claim issue and activity performed in order to resolve. Able to access and obtain claim information and eligibility using insurance payor web portals (including SPOT), in addition to contacting the insurance payers via telephone in order to process pending claims. Conducts review of medical records to identify medical necessity of physician services and submits copies of medical records with the reason for reconsideration for all claim appeals. Attends all educational programs as assigned by manager. Participates in team discussions. Consistently demonstrates the ability to organize work duties, recognize and resolve errors, and establish priorities in order to complete work without creating backlogs. Ability to work as part of a team and share information with team members in order to facilitate and promote excellent quality performance. Responsible for seeking information as needed by reaching out to the team leader, manager and other departments as needed in order to resolve claim issues. Participates in the completion of special collection projects by established deadlines as assigned. Embraces opportunities to acquire more knowledge and shows initiative to learn/improve skills. Any other duties as assigned.