Credit & Collection Rep I (CNPA)

Pay Range: $19.65 - $32.75

About the role

The Credit & Collections Representative 1 (CP&A) will follow up and resolve guarantor/insured liability in accordance with CP&A Policy and Procedure. This role involves establishing and managing guarantor payment agreements, handling incoming calls, and addressing patient and insurance inquiries with high customer service standards.

Responsibilities

• Follow up on guarantor payment agreements and ensure compliance.
• Handle incoming calls between 8:00 AM and 4:30 PM, responding to patient and practice inquiries.
• Resolve patient questions with input from Practice/Provider, Insurance, and Revenue Cycle Manager as needed.
• Review account activity to ensure proper sequencing, filing, and crediting of all insurance, including secondary insurance.
• Review statement activity and billing cycles to ensure patients receive at least two statements before collection activity.
• Document all findings and actions taken on accounts according to CP&A policy.
• Research and resolve insurance questions, contacting payers as needed. Correct, resubmit, or appeal inappropriately denied claims.
• Consult with insurance follow-up teams to ensure appropriate rebill/appeal actions and communicate identified errors or payer changes.
• Verify and apply secondary insurance, filing claims if applicable.
• Contact guarantors to collect balances in full for assigned age groups/practices, following CBO collection guidelines.
• Establish payment arrangements based on CBO procedures and ensure follow-up to honor agreements.
• Manage accounts receivable (AR) aging to resolve guarantor balances within expected timeframes.
• Recommend accounts for transfer to collections if guarantors are non-compliant.
• Process authorized adjustments following CBO procedures.
• Review unapplied cash and work with the Team Leader to transfer if applicable.
• Transfer authorized accounts to collections following CBO procedures.

Requirements

• High School Diploma or GED (Required).
• Minimum of 4 years of experience in a Physician Business Office (Required).

Skills

• Proficiency in computer skills using Windows, Payer Web Search, Excel, and Word.
• Knowledge of insurance billing, reimbursement, and patient liability processes.
• Understanding of guarantor collections and AR processes.
• Familiarity with managed care contracts and insurance compliance.
• Excellent written and oral communication skills.
• Strong customer service skills.

Pay

The disclosed salary range is $19.65 - $32.75. The exact pay rate will be determined based on factors such as market conditions, organizational needs, and the individual’s experience, education, knowledge, and skills.