The Insurance Collector is responsible for claim resolution and payment. The employee works insurance claims and patient accounts using department guidelines and Athena. The position requires a thorough knowledge of insurance carrier billing and reimbursement, CPT, modifiers and fee schedule differences. Also requires understanding of how to decipher explanation of benefits and explain the impact to the customer. Position requires the ability to conduct telephone conversations with patients regarding account resolution and payment collection. Expert verbal communication, interpersonal skills and professional appearance are required. Additional duties as required.
- Effectively resolves unpaid, denied, appeals or overpaid claims while effectively utilizing carrier websites and automated inquiry systems to minimize phone/non-productive time.
- Supports the Biller and Front Desk Staff as needed
- Meet timelines for Athena claims follow up
- Demonstrate interpersonal skills with patients, co-workers and insurance carriers
- Advanced knowledge of CPT codes and modifiers
- Correspondence & voicemails returned within same day 1 business day
- Claim adjudication carrier rules knowledge are current and meets/exceeds monthly performance goals, expectations and reviews.
- Monitors denials for potential trends and effectively communicates these issue with management
- Uses Paid Time Off effectively
- Keeps overtime to a minimum/has any overtime approved by Director
- Actively participates in team meetings and educational opportunities
- Conducts themselves in accordance with Elite DNA Therapy Services Policies and Procedures including the Code of Conduct