Collector-Insurance Verifier

About the role

The Collector-Insurance Verifier at Orlando Ophthalmology Surgery Center is responsible for performing all billing and collection-related duties on patient accounts. This includes preparing and responding to correspondence and records for the release of patient information, coding procedures, and maintaining medical record confidentiality.

Responsibilities

• Identifies procedures and principal diagnosis performed on each patient and properly codes each procedure.
• Prepares batch for dates of services, posts, balances and closes for the day.
• Participates in USPI EDGE program.
• In conjunction with the Medical Records Specialist, responsible for assembling medical chart upon completion, reviewing each chart for completeness, and obtaining missing signatures or documents in a timely manner.
• Prepares charts for doctor's signatures, maintains medical record files, and ensures all aspects of its confidentiality.
• Obtains and files all reports generated by outside vendors.
• Sets charges on patient accounts to correct payer based on verified insurance information. Performs re-bills to insurance payers and patients as needed and supplies additional information as requested.
• Maintains and checks implant tracking log and charges for implants or supplies not included in procedure fee.
• Updates and maintains master copy of all current forms used at the Center.
• Updates charge master for new/deleted procedure or diagnosis codes.
• Mails infection control survey to surgeons, keeps track of statistics, and informs the Clinical Manager of any reported infections. Prepares report for the PI Committee and MEC.
• Obtains surgeon signatures on Operative Reports and completes the Medical Record.
• Maintains log of outstanding Operative Reports and prepares report for the MEC.
• Assures that new physicians have transcription number and information. Resolves any problems with the transcription service.
• Is knowledgeable about current coding conventions and applicable state and federal laws as they pertain to billing, coding, and consents.
• Backs up Accounts Receivable representative as needed.
• Receives, screens, and routes incoming calls in a professional manner by the third ring.
• Informs Business Office Manager of applicable day-to-day situations.

Requirements

• MUST be available to work on site
• Experienced A/R collector
• 1+ years of ASC revenue cycle or charge entry or collections experience.
• Ability to read and interpret insurance explanations of benefits and managed care contracts. Must communicate effectively, both verbally and in writing, with internal and external clients.
• Must be able to multi-task and handle competing priorities while meeting or exceeding deadlines
• Knowledge or experience working with a variety of health care insurance payers is preferred
• Intermediate computer proficiency in Microsoft Office including Excel and Outlook
• Advantx, Vision, HST, Waystar experience preferred.
• High School Diploma or equivalent.