BILLER & COLLECTOR SPECIALIST

We need to output HTML fragment with headings

for sections: Responsibilities, Qualifications, maybe Skills? The posting includes "Professional Skills And Abilities" which could be a Skills section. Also maybe Education under Qualifications. We need to preserve all substantive info, no boilerplate. Remove duplicated lines? There's some duplication: "Responsibilities" appears twice? Actually first line: "Responsibilities The Billing and Collection Specialist, plays a crucial role..." then later "Key Responsibilities". We'll combine into a single Responsibilities section with bullet list. We need to use

• for any list of duties/requirements/benefits. So we need to turn responsibilities into list items. Also qualifications into list items maybe. We must not repeat job title as heading. No Job ID. We must not include Pay/Schedule/Benefits unless present; none present. We must not include filler like "commensurate with experience". Not present. We need to preserve all substantive info: The responsibilities text includes many sentences; we can break into bullet points covering each duty. Qualifications: Education: High school diploma (required) Associates degree in healthcare administration, finance, accounting, or related field (preferred). Experience: Strong understanding of medical terminology, insurance billing practices, and reimbursement processes. Proficiency in using electronic health record (EHR) systems and healthcare billing software, including Meditech or similar platforms. Excellent analytical skills with attention. Previous experience in healthcare billing, revenue cycle management, or accounts receivable preferred. Professional Skills And Abilities: list of many skills. We could combine Experience and Professional Skills into a Skills section? But we have Qualifications heading; we can include subpoints under Qualifications: Education, Experience, Skills. However we need to use
  • for any list. So we can have

    Qualifications

    then
    • Education: ...
    • Experience: ...
    • Skills: ...
    and within Skills maybe another list? Could nest but spec says use
    • for any list of duties/requirements/benefits. It doesn't forbid nested lists but simpler to keep flat. We could also have separate sections: Responsibilities, Qualifications, Skills. But we have both Qualifications and Skills content; we could split: Qualifications (Education + Experience) and Skills (Professional Skills And Abilities). That seems appropriate. Thus sections: Responsibilities, Qualifications, Skills. Now we need to extract responsibilities bullet points. Let's parse responsibilities paragraph: "The Billing and Collection Specialist, plays a crucial role in managing financial transactions, ensuring accuracy, and maintaining compliance. Responsibilities revolve around ensuring accurate and timely billing for assigned service line, analyzing patient accounts, identifying overpayments, processing refunds, and managing credit balances in accordance with established policies and regulations. This position is responsible for supporting and contributing to the team efforts in the achievement of pre-established accounts receivable performance goals of: Net and Gross Days outstanding in Accounts Receivable Percent of Accounts receivable aged greater than 90 days Cash Collection Goals Credit Balances as a Percent to outstanding receivables Denials Resolution The Patient Account Billing and Collection Specialist performs daily activities related to the successful closure of aged accounts receivable Claim submission, corrections and RTPs Perform Account Status and Follow up Resolve Credit Balances Respond to and resolve claim payment denials Correspondence resolution External audit requests related to credit balances Key Responsibilities Utilize the Meditech BAR module to review and analyze patient accounts for accurate billing and collections. Resolve account discrepancies, including rejected or denied claims, by investigating and correcting errors. Review and interpret medical documentation, including medical records, superbills, and encounter forms, to ensure accurate coding and billing. Work closely with healthcare providers and coding staff to clarify any documentation discrepancies or coding-related issues. Generate and submit insurance claims electronically or through paper submission, adhering to all relevant billing regulations and guidelines. Monitor claim statuses and follow up with insurance companies to resolve any outstanding claims or issues. Collaborate with internal departments, such as Registration, Coding, and Finance, to ensure accurate and timely billing processes. Stay updated on industry changes, including coding updates, insurance regulations, and reimbursement policies, and implement necessary changes in billing practices. Maintain accurate records of account management and documentation of billing activities, claim submissions, and payment receipts including Meditech notes and canned text, etc. as directed. Utilize appropriate internal/external applications in conjunction with Meditech to review patient accounts to identify overpayments, duplicate payments and other discrepancies leading to inaccurate account balance. Accurately calculate refunds owed to patients, insurance companies, or other third-party payers. Processes refund requests promptly and efficiently while adhering to the internal protocols and regulatory guidelines. Accurately determines balances and adjustments on accounts that have questionable balances and adjusts accordingly. Monitor and manage credit balances on patient accounts, ensuring timely resolution and appropriate adjustments in accordance with internal protocols and requirements. Collaborate with Cashiers, finance, and payers and applicable third-party vendors to resolve complex refund and credit balance issues. Communicate effectively with patients, insurance representatives, and other stakeholders regarding refund status and inquiries. Maintain detailed records of refund transactions, credit balance adjustments, and related correspondence. Generate reports to track refund activity, credit balance trends, and outstanding issues for management review. Uses proper fee schedules, codes and "caps" as necessary for specific third-party payers. Interprets mail requests from payers, determines necessary action and responds in a timely manner. Interacts with insurance companies to resolve problems, questions, and issues with accounts providing any information required by faxing or mailing records as necessary, not limited to appeals, reconsiderations, telephone follow through, as appropriate per payor. Provide support and guidance to other staff as needed. Respond to external audit requests in relation to credit balances. OMIG and OIG are typical sources in accordance with current internal policy and procedures and regulatory guidelines. Identify opportunities to workflows, enhance efficiency, and minimize errors. Propose and implement process improvements in collaboration with cross-functional teams. Other duties as requested by Supervisor." We need to turn into bullet list items. Could be many; we can group similar but must preserve all substantive info; we can split into separate bullets for each distinct duty. Let's create bullet list: - Plays a crucial role in managing financial transactions, ensuring accuracy, and maintaining compliance. - Ensures accurate and timely billing for assigned service line. - Analyzes patient accounts, identifies overpayments, processes refunds, and manages credit balances in accordance with policies and regulations. - Supports team efforts to achieve pre-established accounts receivable performance goals: - Net and Gross Days outstanding in Accounts Receivable - Percent of Accounts receivable aged greater than 90 days - Cash Collection Goals - Credit Balances as a Percent to outstanding receivables - Denials Resolution - Performs daily activities related to successful closure of aged accounts receivable: claim submission, corrections and RTPs; account status and follow-up; resolve credit balances; respond to and resolve claim payment denials; correspondence resolution; external audit requests related to credit balances. - Utilizes the Meditech BAR module to review and analyze patient accounts for accurate billing and collections. - Resolves account discrepancies, including rejected or denied claims, by investigating and correcting errors. - Reviews and interprets medical documentation (medical records, superbills, encounter forms) to ensure accurate coding and billing. - Works closely with healthcare providers and coding staff to clarify documentation discrepancies or coding-related issues. - Generates and submits insurance claims electronically or via paper submission, adhering to relevant billing regulations and guidelines. - Monitors claim statuses and follows up with insurance companies to resolve outstanding claims or issues. - Collaborates with internal departments (Registration, Coding, Finance) to ensure accurate and timely billing processes. - Stays updated on industry changes (coding updates, insurance regulations, reimbursement policies) and implements necessary changes in billing practices. - Maintains accurate records of account management and documentation of billing activities, claim submissions, and payment receipts (including Meditech notes and canned text) as directed. - Utilizes appropriate internal/external applications with Meditech to review patient accounts to identify overpayments, duplicate payments, and other discrepancies leading to inaccurate account balance. - Accurately calculates refunds owed to patients, insurance companies, or other third-party payers. - Processes refund requests promptly and efficiently while adhering to internal protocols and regulatory guidelines. - Accurately determines balances and adjustments on accounts with questionable balances and adjusts accordingly. - Monitors and manages credit balances on patient accounts, ensuring timely resolution and appropriate adjustments per internal protocols and requirements. - Collaborates with Cashiers, finance, payers, and applicable third-party vendors to resolve complex refund and credit balance issues. - Communicates effectively with patients, insurance representatives, and other stakeholders regarding refund status and inquiries. - Maintains detailed records of refund transactions, credit balance adjustments, and related correspondence. - Generates reports to track refund activity, credit balance trends, and outstanding issues for management review. - Uses proper fee schedules, codes, and "caps" as necessary for specific third-party payers. - Interprets mail requests from payers, determines necessary action, and responds timely. - Interacts with insurance companies to resolve problems, questions, and issues with accounts, providing required information via fax, mail, appeals, reconsiderations, telephone follow-up as appropriate per payer. - Provides support and guidance to other staff as needed. - Responds to external audit requests related to credit balances (OMIG and OIG typical sources) per internal policy and regulatory guidelines. - Identifies opportunities to enhance workflows, improve efficiency, and minimize errors. - Proposes and implements process improvements in collaboration with cross-functional teams. - Performs other duties as requested by Supervisor. That seems comprehensive. Now Qualifications section: Education and Experience. Education bullet: High school diploma (required); Associates degree in healthcare administration, finance, accounting, or related field (preferred). Experience bullet: Strong understanding of medical terminology, insurance billing practices, and reimbursement processes; Proficiency in using electronic health record (EHR) systems and healthcare billing software, including Meditech or similar platforms; Excellent analytical skills with attention; Previous experience in healthcare billing, revenue cycle management, or accounts receivable preferred. We could split into multiple bullets for clarity. Skills section: Professional Skills And Abilities list. List items: - Excellent interpersonal skills with ability to interact effectively with all levels of employees and clients - Ability to work in a team-oriented environment - Excellent written and verbal communication skills - Knowledge of Health Care industry - Detail oriented - Strong organizational skills - Ability to analyze and problem solve - Ability to work with accuracy and attention to detail - Ability to prioritize and handle multiple tasks simultaneously - Cooperative work attitude toward and with co-employees, management, patients, and outside contacts - Ability to promote favorable company image with patients, insurance companies, and general public - Ability to quickly grasp new processes - Excellent written/verbal communication (duplicate? but we keep) - Well organized We could combine duplicates but preserve info; maybe keep as separate but could deduplicate. The instruction: "Preserve ALL substantive information; do NOT invent or summarize away detail." Duplicates are substantive? They are repeated; we could keep one instance but that's summarizing away detail? It's duplicate; removing duplicate is not inventing or summarizing away detail? It's removing redundancy but still preserving the info. Probably acceptable to deduplicate. But safer to keep both? Might be considered filler? Not exactly filler. I'd deduplicate to avoid redundancy. Thus Skills list: - Excellent interpersonal skills with ability to interact effectively with all levels of employees and clients - Ability to work in a team-oriented environment - Excellent written and verbal communication skills - Knowledge of Health Care industry - Detail oriented - Strong organizational skills - Ability to analyze and problem solve - Ability to work with accuracy and attention to detail - Ability to prioritize and handle multiple tasks simultaneously - Cooperative work attitude toward and with co-employees, management, patients, and outside contacts - Ability to promote favorable company image with patients, insurance companies, and general public - Ability to quickly grasp new processes - Well organized Now produce HTML fragment:

      Responsibilities

      • ...