Third Party Collector - Revenue Integrity - Days - FT

Job Summary:

Monitors assigned encounters to ensure maximum collection of dollars by providing appropriate follow-up and documentation. Collaborates with other department staff in the organization, insurance companies, physician offices, and patients or guarantors. Complies with organization and department policies and procedures.

Required Qualifications:

Education:  High School graduate or equivalent.

Licensure:  N/A   

Experience:  One (1) year of experience in patient and medical insurance follow up in a healthcare setting.  Certification in Billing or Coding may substitute for experience.

Skills, Knowledge, Abilities:  Proficiency with computers and software applications. Knowledge of general office procedures. Knowledge of payor environments, such as managed care; insurance contractual agreements and appeals process. Excellent interpersonal and communication skills. Advanced abilities in basic mathematical skills.

Preferred Qualifications:

Education:  Associates degree or completed courses in computer science, communication accounting, billing or coding.

Licensure:  Certification in Medical Billing or Coding.   

Experience:  Experience in commercial; Medicare or Medicaid follow-up.

Skills, Knowledge, Abilities:  Ability to work independently. Excellent verbal and writing skills. Knowledge of billing and government programs. Basic knowledge of the Fair Debt Collection Practices Act; f the False Claims Act as it pertains to the Patient Protection and Affordable Care Act, PPACA; general knowledge of ICD-9/10, CPT, and DRG codes; knowledge of the Red Flag Rule, created by the FTC under the Fair and Accurate Credit Transactions Act of 2003.