Representative Collections L1

POSITION SUMMARYCollections Representative is responsible for follow up on delinquent surgery center claims working an expected number of claims per day. Majority of claims will have been submitted to various insurance carriers electronically. Knowledge of how to interpret a managed care contract Medicare and Medicaid and Workers Compensation claims is a must. You will be given tools to calculate allowable and required to determine appropriateness of reimbursement and appeal claims as FUNCTIONSContact payors and patients to effectively and accurately collect for services provided by Atlas a managed care contracts Medicare and Medicaid and Workers Compensation to appropriately calculate allowable and determine appropriateness of patient eligibility and plan structure to determine patient questions regarding account aging denial types and other requests for analysis and detail by account center denial type or any other claim and invoice as a team player and have ability to communicate well with team members patients customers insurance carriers etc. Apply the appropriate strategy to account resolution including thresholds for refunds recoups write offs adjustments and productivity work payments adjustments claims correspondence refunds denials financial/charity applications and/or payment to help the team meet goals in work quality and productivity. Identifies payer center and denial trends and shares those results with collections all functions according to established policies procedures regulatory and accreditation requirements as well as applicable professional standards. Provides all customers with an excellent service experience by consistently demonstrating our core and leader behaviors each and every : The essential functions are intended to describe the general content of and requirements of this position and are not intended to be an exhaustive statement of duties. Specific tasks or responsibilities will be documented as outlined by the incumbents immediate FUNCTIONSContact payors and patients to effectively and accurately collect for services provided by Atlas a managed care contracts Medicare and Medicaid and Workers Compensation to appropriately calculate allowable and determine appropriateness of reimbursement Interpret patient eligibility and plan structure to determine patient responsibilityAnswer questions regarding account aging denial types and other requests for analysis and detail by account center denial type or any other claim and invoice characteristicsParticipate as a team player and have ability to communicate well with team members patients customers insurance carriers etc. Apply the appropriate strategy to account resolution including thresholds for refunds recoups write offs adjustments and productivity work payments adjustments claims correspondence refunds denials financial/charity applications and/or payment to help the team meet goals in work quality and productivity. Identifies payer center and denial trends and shares those results with collections all functions according to established policies procedures regulatory and accreditation requirements as well as applicable professional standards. Provides all customers with an excellent service experience by consistently demonstrating our core and leader behaviors each and every : The essential functions are intended to describe the general content of and requirements of this position and are not intended to be an exhaustive statement of duties. Specific tasks or responsibilities will be documented as outlined by the incumbents immediate QUALIFICATIONSHigh school diploma or GED required. Requires knowledge of at least one of the following: patient financial services financial collecting services or insurance industry experience processes normally acquired over up to two years of work the ability to manage multiple tasks simultaneously with minimal supervision and to work strong interpersonal oral and written communication skills to effectively interact with a wide range of knowledge in the use of common office software word processing spreadsheet and database software are QUALIFICATIONSAdditional related education and/or experience DEMANDS/ENVIRONMENT FACTORS OE - Typical Office Environment: (Accountant Administrative Assistant Consultant Program Manager) Requires extensive sitting with periodic standing and walking. May be required to lift up to 20 pounds. Requires significant use of personal computer phone and general office equipment. Needs adequate visual acuity ability to grasp and handle objects. Needs ability to communicate effectively through reading writing and speaking in person or on telephone. May require off-site RESPONSIBILITIES NoneDIRECTLY REPORTINGSupervisor - Payment& Support OperationsTYPE OF SUPERVISORY RESPONSIBILITIESN/ASCOPE AND COMPLEXITYWorks independently under regular supervision and follows structured work routines. Works in a fast paced multitask environment with high volume and immediacy needs requiring independent decision making and sound judgment to prioritize work and ensure appropriateness and timeliness of each patients care. This position requires the ability to retain large amounts of changing payor information/knowledge crucial to attaining reimbursement for the services provided. Primary external customers include patients and their families physician office staff and third-party payors.