Medical Insurance Collector in Livermore, CA
- Title: Medical Insurance Collector
- Code: RCI-37683
- RequirementID: 121819
- Location: Livermore, CA 94550
- Posted Date: 10/14/2024
- Duration: 12 , extension possible based on needs and performance
Position Title: Medical Insurance Collector - Level I, II, and III
The position of Medical Insurance Collector - Level I, II, and III is within our INR Revenue Cycle located at Livermore, California.
In this role, you will handle and resolve all insurance follow up and denial issues to ensure that company receives correct reimbursements from the insurance companies.
The incumbent will:
- Serve as the liaison between insurance companies, patients and the departments;
- Ensure claims are processed and followed up to meet company goals of account receivable days, aging account percentages and cash goals;
- Research and answer all questions and complaints, regarding patient responsibility balances and billing inquiries sent to them through the customer call center with the highest degree of courtesy and professionalism.
This job description will be reviewed periodically and is subject to change by management.
RESPONSIBILITIES:
- Demonstrates proficiency and accuracy in operating systems directly related to specific job function.
- Initiates contact with insurance carriers regarding status on claims.
- Maintains accurate and complete collection notes concerning collection activities on all accounts according to company procedures and requirements.
- Can work independently.
- Takes incoming calls from insurance carriers and patients.
- Contributes to team effort by accomplishing related results as needed.
- Ensures that all processing and reporting deadlines are consistently achieved.
- Maintain compliance with all company policies and procedures.
- Regular attendance and punctuality.
- Performs any other function as required by management.
Key Results:
- Represents company and team in a professional and positive manner.
- Meet and exceed daily and monthly production goal.
- Effective communications with staff and management.
- Demonstrates basic understanding of billing system; able to complete basic tasks based on job function.
- Adapts to changing business needs, conditions, work responsibilities.
- Able to toggle between computer screens.
- Exhibit competency in the utilization of computers, telephones, calculators, fax machines and devices-level of competency 90%.
- Follow work list prioritization of accounts as established by department policies and procedures.
- Responsible for all aspects of follow up on accounts, including contacting payers and patients when necessary and accessing payer websites.
- Accurately document accounts collection notes.
- Responsible for processing appeals and researching of claims.
- Follow specific payer guidelines for appeals submission.
- Prioritize and manage accounts to resolve high priority-high dollar accounts and aging.
- Complete AR adjustments where appropriate.
- Demonstrates knowledge of government payers guidelines (Medicare/Medicaid).
- Comply with adhere to all regulatory compliance areas, policies, and procedures (including HIPPAA and PCI compliance requirements).
- Regular attendance and punctuality.
- Performs any other function as required by management.
Key Results:
- Working Denials in a timely manner that results in cash collection goals.
- Represent company and team in a professional and positive manner.
- Meet and exceed daily and monthly productivity goals.
- Detailed oriented, careful and with a focus on quality in accomplishing tasks.
- Able to toggle between computer screens
- Issues identified and resolved within an average of 48 hours.
- Adapts to changing business needs, conditions, and work responsibilities.
- Effective communications with staff and management.
- Always maintain confidentiality.
- Present ideas for improvements and strategies to meet goals. Offer viable solutions to problems.
- Promote teamwork, remaining available to assist staff as needed.
- Performs any other function as required by management.
- Report to manager any non-compliance with staff as observed by you.
- Participate in personal development training and cross training as instructed by management.
BASIC QUALIFICATIONS | EDUCATION:
- High school diploma or GED required
- Preferred years of experience - Level one representative 1 to 3, Level two representative 3 to 5 and Level three 5+.
- Excellent verbal and written communication skills, including ability to effectively communicate with internal and external customers.
- Excellent computer proficiency (MS Office – Word, Excel and Outlook)
- Must be able to work under pressure and meet deadlines, while maintaining a positive attitude and providing exemplary customer service
- Ability to work independently and to carry out assignments to completion within parameters of instructions given, prescribed routines, and standard accepted practices
COMPETENCIES:
Behavioral Standards:
- Exhibits customer and service-oriented behaviors in every day work interactions.
- Demonstrates a courteous and respectful attitude to internal workforce and external customers.
- Treat others with unconditional respect, dignity and equality
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.
- 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
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