• Responsible for all aspects of follow up and collections, including making telephone calls, accessing payer websites. Identify issues or trending and provide suggestions for resolution. Accurately and thoroughly documents the pertinent collection activity performed. Review the account information and necessary system applications to determine the next appropriate work activity. Verify claims adjudication utilizing appropriate resources and applications. Initiate telephone or letter contact to patients to obtain additional information as needed. Perform appropriate billing functions, including manual re-bills as well as electronic submission to payers. Edit claims to meet and satisfy billing compliance guidelines for electronic submission. Manage and maintain desk inventory, complete reports, and resolve high priority and aged inventory.
• Participate and attend meetings, training seminars and in-services to develop job knowledge. Participate in the monthly, quarterly and annual performance evaluation process with their Supervisor. Respond timely to emails and telephone messages as appropriate. Communicate issues to management, including payer, system or escalated account issues.
  
  

KNOWLEDGE, SKILLS, ABILITIES

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Good written and verbal communication skills
• Intermediate technical skills including PC and MS Outlook
• Intermediate knowledge of UB-04 and Explanation of Benefits (EOB) interpretation
• Intermediate knowledge of CPT and ICD-9 codes
• Intermediate knowledge of insurance collections and insurance terminology

EDUCATION / EXPERIENCE

• High school diploma or equivalent education
• 0-4 years of experience in Medical/Hospital Insurance related collections

PHYSICAL DEMANDS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

WORK ENVIRONMENT

• Office/Team Work Environment

Employment practices will not be influenced or affected by an applicant’s or employee’s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.