Collections Representative -

Company: PRIDE Health
Location: Philadelphia
Posted on: January 27, 2023

Job Description:

Russell Tobin is looking for a Collections Representative to work for our client in Philadelphia, PALocation: Cira Centre, 2929 Arch St, Philadelphia, PA 19104Pay: $21 per hour Summary: Responsible for ensuring correct and timely reimbursement from third party payors for services provided by Children's Anesthesiology Associates, Ltd. (CAA). The Collections Rep will appeal, re-bill, and perform other necessary actions to collect revenue due CAA. The Collections Rep will be involved in other AR related projects on a daily basis. The Collections Rep will employ appropriate resources to investigate, analyze, identify and reduce barriers to correct adjudication, such as issues involving Network Set-Up, Fee Schedules, Denial Management, and Contract Compliance. The primary focus of this position is to maximize reimbursements through the timely follow up of accounts.Responsibilities:

• Proven working experience as a Collections/Account Receivable Rep
• Solid understanding of insurance follow-up, denials, reimbursements, contracts and insurance policies
• Investigate Accounts identified as low pays, denials, or otherwise (75%)
• Review accounts in work file/queue and take appropriate steps to resolve accounts in compliance with CAA's contracts, agreements, or appropriate measures.
• Contact insurance company/third parties by telephone, letter, fax, e-mail, etc. as needed.
• Include complete and appropriate comments on actions taken to resolve accounts.
• Review and perform analysis and trending to identify possible barriers to correct and timely claim submission, claim processing, provider enrollment, among others which may result in non-payments, delayed payments, or low payments.
• Transfer accounts when necessary and only after confirming updated registration or eligibility.
• Ensure that all claim submissions, appeals, and requested information is provided within the required time frame to avoid timely filing issues and processing delays.
• Properly handle all other insurance explanation of benefits that require other activities or reconciliation.
• Request and include correct and appropriate attachments as required and in accordance with policies and procedures.
• Assist with special projects, audits and reconciliation as necessary.
• Reconcile credit balances and submit requests for refunds in accordance with policies or when applicable or contact Payor to initiate off-sets/retractions of incorrectly paid services when possible. (15%)
• Investigate and submit for approval write off allowances and/or adjustments that have reasonable justification in accordance with CAA's contracts and policies. (10%)
• Interact professionally and productively with Co-workers and CHOP staff in areas such as registration, Physician Billing, and Patient Access and Revenue Cycle, and others.
• Meet minimum production and performance target goals.
• Work correspondence daily.
• Other duties as assigned.Skills: Needs someone with min 5-7 years of insurance follow-up, AR collection, denial management for commercial and government payors. Anesthesia experience is preferred. EPIC experience is necessary. --- Knowledge of word processing, electronic mail, and spreadsheet applications.--- Must be proficient in Microsoft Excel. Must be comfortable working with large data sets.--- Excellent analytic skills.--- Excellent interpersonal and organization skills.--- Ability to handle multiple tasks, meet deadlines and handle confidential materials.--- Excellent phone etiquette. Strong customer service and phone skills.--- Epic experience is preferredEducation: High school diploma or equivalent with three years experience in the medical field preferably with physician billing/collections. Rate/Salary:

Keywords: PRIDE Health, Philadelphia , Collections Representative -, Accounting, Auditing , Philadelphia, Pennsylvania