Medical Collections Representative

About the role

We are currently seeking a Medical Collections Representative who will play a critical role in ensuring the financial health of the organization by managing patient accounts, verifying eligibility and benefits, and overseeing collections activities.

Responsibilities

• Determine and update copayment, coinsurance, deductible, and out-of-pocket amounts.
• Verify eligibility and benefits using a real-time system response, through health plan portals, and/or via telephone to the health plan and/or guarantor.
• Responsible for verifying COB information and communicating with the health plan and/or guarantor.
• Manage a portfolio of assigned accounts that are aged in a timely manner.
• Maximize revenue by providing appropriate follow-up and document actions taken.
• Ability to read and interpret an explanation of benefits.
• Knowledge of a CMS-1500 claim form and field requirements.
• Effective appeal writing skills to submit claim appeals with supporting documentation per payor policy/guidelines.
• Maintain compliance with healthcare regulations, deliver exceptional customer service, and support efficient billing workflows to enhance operational efficiency and patient satisfaction.
• Collaborate with patients or customers, third party institutions and other team members to research and resolve billing inconsistencies and errors.
• Collect and maintain patient demographic and medical information required for medical billing.
• Ensure patient documentation is scanned and filed correctly within the Electronic Medical Record (EMR).
• Provide exceptional customer service.
• Maintain and understand various medical billing software platforms.
• Navigate insurance websites and answer customer inquiries.
• Understand office visit fees including procedure and diagnosis codes.
• Maintain confidentiality and adhere to HIPAA regulations.
• Complete assigned tickets as required.
• Adhere to policies and procedures, update of forms and manuals.
• Assist in development and communication of SOP for key areas to improve accuracy and understanding of processes.
• Support daily, weekly, and monthly medical billing metrics.
• Identify issues and present possible solutions and/or suggestions to management.
• Interfaces with other departments to resolve medical billing workflows.
• Aid in the development of SOPs for key areas to improve accuracy and understanding of processes.
• Support daily, weekly, and monthly medical billing metrics.
• Identify issues and present possible solutions and/or suggestions to management.
• Interfaces with other departments to resolve medical billing workflows.
• Aid in the development of SOPs for key areas to improve accuracy and understanding of processes.
• Support daily, weekly, and monthly medical billing metrics.
• Identify issues and present possible solutions and/or suggestions to management.
• Interfaces with other departments to resolve medical billing workflows.
• Aid in the development of SOPs for key areas to improve accuracy and understanding of processes.
• Support daily, weekly, and monthly medical billing metrics.
• Identify issues and present possible solutions and/or suggestions to management.
• Interfaces with other departments to resolve medical billing workflows.
• Aid in the development of SOPs for key areas to improve accuracy and understanding of processes.
• Support daily, weekly, and monthly medical billing metrics.
• Identify issues and present possible solutions and/or suggestions to management.
• Interfaces with other departments to resolve medical billing workflows.
• Aid in the development of SOPs for key areas to improve accuracy and understanding of processes.
• Support daily, weekly, and monthly medical billing metrics.
• Identify issues and present possible solutions and/or suggestions to management.
• Interfaces with other departments to resolve medical billing workflows.
• Aid in the development of SOPs for key areas to improve accuracy and understanding of processes.
• Support daily, weekly, and monthly medical billing metrics.
• Identify issues and present possible solutions and/or suggestions to management.
• Interfaces with other departments to resolve medical billing workflows.
• Aid in the development of SOPs for key areas to improve accuracy and understanding of processes.
• Support daily, weekly, and monthly medical billing metrics.
• Identify issues and present possible solutions and/or suggestions to management.
• Interfaces with other departments to resolve medical billing workflows.
• Aid in the development of SOPs for key areas to improve accuracy and understanding of processes.
• Support daily, weekly, and monthly medical billing metrics.
• Identify issues and present possible solutions and/or suggestions to management.
• Interfaces with other departments to resolve medical billing workflows.
• Aid in the development of SOPs for key areas to improve accuracy and understanding of processes.
• Support daily, weekly, and monthly medical billing metrics.
• Identify issues and present possible solutions and/or suggestions to management.
• Interfaces with other departments to resolve medical billing workflows.
• Aid in the development of SOPs for key areas to improve accuracy and understanding of processes.
• Support daily, weekly, and monthly medical billing metrics.
• Identify issues and present possible solutions and/or suggestions to management.
• Interfaces with other departments to resolve medical billing workflows.
• Aid in the development of SOPs for key areas to improve accuracy and understanding of processes.
• Support daily, weekly, and monthly medical billing metrics.
• Identify issues and present possible solutions and/or suggestions to management.
• Interfaces with other departments to resolve medical billing workflows.
• Aid in the development of SOPs for key areas to improve accuracy and understanding of processes.
• Support daily, weekly, and monthly medical billing metrics.
• Identify issues and present possible solutions and/or suggestions to management.
• Interfaces with other departments to resolve medical billing workflows.
• Aid in the development of SOPs for key areas to improve accuracy and understanding of processes.
• Support daily, weekly, and monthly medical billing metrics.
• Identify issues and present possible solutions and/or suggestions to management.
• Interfaces with other departments to resolve medical billing workflows.
• Aid in the development of SOPs for key areas to improve accuracy and understanding of processes.
• Support daily, weekly, and monthly medical billing metrics.
• Identify issues and present possible solutions and/or suggestions to management.
• Interfaces with other departments to resolve medical billing workflows.
• Aid in the development of SOPs for key areas to improve accuracy and understanding of processes.
• Support daily, weekly, and monthly medical billing metrics.
• Identify issues and present possible solutions and/or suggestions to management.
• Interfaces with other departments to resolve medical billing workflows.
• Aid in the development of SOPs for key areas to improve accuracy and understanding of processes.
• Support daily, weekly, and monthly medical billing metrics.
• Identify issues and present possible solutions and/or suggestions to management.
• Interfaces with other departments to resolve medical billing workflows.
• Aid in the development of SOPs for key areas to improve accuracy and understanding of processes.
• Support daily, weekly, and monthly medical billing metrics.
• Identify issues and present possible solutions and/or suggestions to management.
• Interfaces with other departments to resolve medical billing workflows.
• Aid in the development of SOPs for key areas to improve accuracy and understanding of processes.
• Support daily, weekly, and monthly medical billing metrics.
• Identify issues and present possible solutions and/or suggestions to management.
• Interfaces with other departments to resolve medical billing workflows.
• Aid in the development of SOPs for key areas to improve accuracy and understanding of processes.
• Support daily, weekly, and monthly medical billing metrics.
• Identify issues and present possible solutions and/or suggestions to management.
• Interfaces with other departments to resolve medical billing workflows.
• Aid in the development of SOPs for key areas to improve accuracy and understanding of processes.
• Support daily, weekly, and monthly medical billing metrics.
• Identify issues and present possible solutions and/or suggestions to management.
• Interfaces with other departments to resolve medical billing workflows.
• Aid in the development of SOPs for key areas to improve accuracy and understanding of processes.
• Support daily, weekly, and monthly medical billing metrics.
• Identify issues and present possible solutions and/or suggestions to management.
• Interfaces with other departments to resolve medical billing workflows.
• Aid in the development of SOPs for key areas to improve accuracy and understanding of processes.
• Support daily, weekly, and monthly medical billing metrics.
• Identify issues and present possible solutions and/or suggestions to management.
• Interfaces with other departments to resolve medical billing workflows.
• Aid in the development of SOPs for key areas to improve accuracy and understanding of processes.
• Support daily, weekly, and monthly medical billing metrics.
• Identify issues and present possible solutions and/or suggestions to management.
• Interfaces with other departments to resolve medical billing workflows.
• Aid in the development of SOPs for key areas to improve accuracy and understanding of processes.
• Support daily, weekly, and monthly medical billing metrics.
• Identify issues and present possible solutions and/or suggestions to management.
• Interfaces with other departments to resolve medical billing workflows.
• Aid in the development of SOPs for key areas to improve accuracy and understanding of processes.
• Support daily, weekly, and monthly medical billing metrics.
• Identify issues and present possible solutions and/or suggestions to management.
• Interfaces with other departments to resolve medical billing workflows.
• Aid in the development of SOPs for key areas to improve accuracy and understanding of processes.
• Support daily, weekly, and monthly medical billing metrics.
• Identify issues and present possible solutions and/or suggestions to management.
• Interfaces with other departments to resolve medical billing workflows.
• Aid in the development of SOPs for key areas to improve accuracy and understanding of processes.
• Support daily, weekly, and monthly medical billing metrics.
• Identify issues and present possible solutions and/or suggestions to management.
• Interfaces with other departments to resolve medical billing workflows.
• Aid in the development of SOPs for key areas to improve accuracy and understanding of processes.
• Support daily, weekly, and monthly medical billing metrics.
• Identify issues and present possible solutions and/or suggestions to management.
• Interfaces with other departments to resolve medical billing workflows.
• Aid in the development of SOPs for key areas to improve accuracy and understanding of processes.
• Support daily, weekly, and monthly medical billing metrics.
• Identify issues and present possible solutions and/or suggestions to management.
• Interfaces with other departments to resolve medical billing workflows.
• Aid in the development of SOPs for key areas to improve accuracy and understanding of processes.
• Support daily, weekly, and monthly medical billing metrics.
• Identify issues and present possible solutions and/or suggestions to management.
• Interfaces with other departments to resolve medical billing workflows.
• Aid in the development of SOPs for key areas to improve accuracy and understanding of processes.
• Support daily, weekly, and monthly medical billing metrics.
• Identify issues and present possible solutions and/or suggestions to management.
• Interfaces with other departments to resolve medical billing workflows.
• Aid in the development of SOPs for