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Provides medical collection services for TLRA collection units. Utilizes a strong background as a medical collection specialist to successfully resolve accounts placed with TLRA for collection. This involves performing collection activities related to follow-up and account resolution and includes communication with patients, clients, reimbursement vendors, and other external entities while adhering to all client, state, and federal guidelines. Patient and client satisfaction is essential. Associates in the collection units are expected to have knowledge of the overall collection work processes for both active AR and BD inventory.
Job Responsibility
Provides medical collection services for TLRA collection units
Performs collection activities related to follow-up and account resolution
Communication with patients, clients, reimbursement vendors, and other external entities
Documents and updates patient account information in TLRA’s collection software system
Handles inbound patient and/or carrier calls
Uses collection tools effectively to ensure quality recovery services
Performs research and analysis of account issues
Ensure daily productivity standards are met
Promotes positive patient relations
Maintains active knowledge of all collection requirements by payors
Collects balance owing from third-party payers
Ensures quality standards are met and proper documentation regarding patient accounting records
Contact other departments to obtain necessary information for appeals
Ensures that self-pay accounts are handled in a customer service-oriented manner
Responsible for assisting patients in identifying eligible means of financial assistance
Must participate in team meetings, communicate work-related ideas and concerns proactively
Ensure proper reimbursement for all services and to ensure all appeals are filed timely
Review accounts and determine appropriate follow-up activities utilizing Six Sigma Practices
Identify under and overpayments and take appropriate actions to resolve accounts
Validate commercial insurance claims to ensure the claims are paid according to the contract
Direct knowledge using Meditech and CollectLogix software
Monitor and communicate errors generated by other groups and evaluate for trends
Performs other special projects as required when assigned
Requirements
High School diploma or equivalent years of experience required
3-5 years of experience preferred
experience in a Customer Service call center environment with a focus on healthcare billing/collections or collection agency environment required
College education, previous Insurance Company claims experience and/or health care billing trade school education may be considered in lieu of formal hospital experience
General hospital A/R accounts knowledge is required
Must have solid knowledge and utilization of desktop applications to include Word and Excel are essential