Medical Billing _ Accounts Receivables Collector

$37,440 - $39,520/Yr

Medical Ar Management Services - Houston, TX

Full-time - Entry Level

Houston, TX

Professional, Scientific, and Technical Services

About the position

We are seeking a detail-oriented Medical Accounts Receivable Collector to join our team at Medical AR Management Services LLC. The ideal candidate will have a background in medical collections and possess knowledge of medical terminology and coding systems. This position is crucial for maintaining industry standards for the accounts receivable (A/R) assigned to all carriers, focusing on aging, collection rates, appeals, rejections, and claims with no activity. The collections specialist will be responsible for posting adjustments as needed and following up on all outstanding insurance claims. The role requires working on aging reports as directed by the A/R Manager and is tasked with lowering A/R over 90 days to acceptable standards. Timely follow-up with internal and external customers, as well as third-party payers, is essential to ensure compliance with all policies and procedures. The essential duties include researching claims and refiling or appealing as necessary based on a review of coding, contractual issues, and data entry errors. The specialist will monitor payer rejects and denials to identify systemic or data entry issues and report any irregularities to management. Daily follow-up on all outstanding assigned insurance claims and claim reports generated based on rejections, appeals, and denials by the insurance carriers is required. The role also involves posting contractual adjustments and transferring deductibles to patient accounts based on correspondence from insurance carriers. The collections specialist will assist with claim resubmission projects when necessary and work with supervisors to streamline billing procedures based on denial types. Additionally, the specialist will research and resolve unpaid claims, correct errors on a daily basis, and prepare spreadsheets on unpaid or partial pay claims for resubmission to payers. Handling correspondence from insurance companies, including denials and information requests, as well as incoming calls from patients and insurance companies regarding claims and patient balances, is also part of the job. The position requires reviewing accounts to determine if they were billed correctly and performing other related duties as assigned or described in company policy.

Responsibilities

• Maintain industry standards for assigned A/R regarding aging, collection rates, appeals, rejections, and claims with no activity.
• Post adjustments as needed and follow up on all outstanding insurance claims.
• Work on aging reports as directed by the A/R Manager.
• Lower A/R over 90 days to acceptable standards.
• Timely follow-up with internal and external customers and third-party payers.
• Research claims and refile/appeal as necessary based on coding, contractual issues, and data entry errors.
• Monitor payer rejects and denials to determine systemic or data entry issues and report irregularities to management.
• Daily follow up on all outstanding assigned insurance claims.
• Daily follow up on claim reports generated based on rejections, appeals, and denials by insurance carriers.
• Post contractual adjustments and transfer deductibles to patient accounts based on correspondence from insurance carriers.
• Assist with claim resubmission projects when necessary.
• Work with supervisors to streamline billing procedures based on denial types.
• Research and resolve unpaid claims and correct errors on a daily basis.
• Review accounts that have partial or under payments.
• Prepare spreadsheets on unpaid or partial pay claims for resubmission to payers.
• Handle correspondence from insurance companies including denials, information requests, or refund requests.
• Handle incoming calls from patients and insurance companies regarding claims and patient balances.
• Review accounts to determine if billed correctly.

Requirements

• 3 years' experience in healthcare collections setting.
• 3 years' experience with Medicare, Medicaid, and Commercial carriers' collections.
• Ability to read explanation of benefits (EOBs).
• Strong cognitive skills including analysis, problem solving, high attention to detail, and decision making.
• Ability to work collaboratively with other team members to support data quality and integrity initiatives.
• Great organizational skills and ability to work on multiple assignments concurrently within established timeframes.
• Ability to multi-task, establish and meet deadlines, and work in a fast-paced environment while maintaining accuracy.
• Strong verbal and written communication skills.
• Ability to troubleshoot and recommend root cause solutions to problems.
• Above average organizational and time management skills.
• Strong Microsoft Office experience with emphasis on Excel (intermediate to advanced).
• Knowledge of Federal, state, and HIPAA privacy regulations.

Nice-to-haves

• ACPC certification preferred but not required.