United Surgical Partners International, Inc
Hospital A/R Collector
United Surgical Partners International, Inc, Dallas, Texas, United States, 75215
Overview
Hospital A/R Collector role at United Surgical Partners International, Inc. This position reports to the Hospital Collections Supervisor and requires strong knowledge of medical collections, accounts receivables, insurance billing and verification, denial processing, appeal submission and EOB review. The Collector is responsible for resolving outstanding surgical claims to maximize reimbursement. Responsibilities
Timely follow-up and resolution on all outstanding A/R including unpaid/underpaid/denied claims for all payers including self-pay to obtain maximum reimbursement. Manage daily work queue to prioritize high dollar claim balances. Perform insurance claim follow-ups for insurance denials and appeals; contact insurance companies to check eligibility and benefits via phone or online. Review payer contracts to ensure claims have processed correctly. Knowledge of all payers MCR, MCR ADVG, Medicaid, Medicare Advantage, and Commercial payers. Review and work incoming insurance and patient correspondence including refund requests. Prepare and write medical necessity appeals when appropriate or provide the requested medical documentation. Ability to review medical documentation to justify medical necessity. Review patient balances to ensure accuracy and follow up with patients to obtain payments. Review insurance payments and determine accuracy of reimbursement based on contracts, fee schedules or summary plan documents. Leverage knowledge of Medicare, state Medicaid, and local coverage determinations (LCDs) for claim resolution. Negotiate payment amounts for procedures with Third Party Administrators for out of network providers. Recommend an adjustment when applicable or a refund for overpayments to insurance carriers or patients, providing the appropriate documentation. Requirements / Qualifications
3+ years of hospital collections experience preferred. Excellent communication and interpersonal skills Skilled in time management and prioritization of emergent situations Excellent customer service skills, demonstrating professionalism Ability to read and interpret insurance explanations of benefits and managed care contracts Knowledge or experience with a variety of health care insurance payers is preferred Intermediate proficiency in Microsoft Office (Excel, Outlook) Experience with DDE, Ability Easse, nThrive, Cerner, Advantx, Vision, HST, Waystar preferred High School Diploma or equivalent Seniority level
Mid-Senior level Employment type
Full-time Job function
Accounting/Auditing and Finance Industries: Hospitals and Health Care
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Hospital A/R Collector role at United Surgical Partners International, Inc. This position reports to the Hospital Collections Supervisor and requires strong knowledge of medical collections, accounts receivables, insurance billing and verification, denial processing, appeal submission and EOB review. The Collector is responsible for resolving outstanding surgical claims to maximize reimbursement. Responsibilities
Timely follow-up and resolution on all outstanding A/R including unpaid/underpaid/denied claims for all payers including self-pay to obtain maximum reimbursement. Manage daily work queue to prioritize high dollar claim balances. Perform insurance claim follow-ups for insurance denials and appeals; contact insurance companies to check eligibility and benefits via phone or online. Review payer contracts to ensure claims have processed correctly. Knowledge of all payers MCR, MCR ADVG, Medicaid, Medicare Advantage, and Commercial payers. Review and work incoming insurance and patient correspondence including refund requests. Prepare and write medical necessity appeals when appropriate or provide the requested medical documentation. Ability to review medical documentation to justify medical necessity. Review patient balances to ensure accuracy and follow up with patients to obtain payments. Review insurance payments and determine accuracy of reimbursement based on contracts, fee schedules or summary plan documents. Leverage knowledge of Medicare, state Medicaid, and local coverage determinations (LCDs) for claim resolution. Negotiate payment amounts for procedures with Third Party Administrators for out of network providers. Recommend an adjustment when applicable or a refund for overpayments to insurance carriers or patients, providing the appropriate documentation. Requirements / Qualifications
3+ years of hospital collections experience preferred. Excellent communication and interpersonal skills Skilled in time management and prioritization of emergent situations Excellent customer service skills, demonstrating professionalism Ability to read and interpret insurance explanations of benefits and managed care contracts Knowledge or experience with a variety of health care insurance payers is preferred Intermediate proficiency in Microsoft Office (Excel, Outlook) Experience with DDE, Ability Easse, nThrive, Cerner, Advantx, Vision, HST, Waystar preferred High School Diploma or equivalent Seniority level
Mid-Senior level Employment type
Full-time Job function
Accounting/Auditing and Finance Industries: Hospitals and Health Care
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