Biller / Collector
11/3/2009
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Job Overview
Company:
Location:
Base Pay: N/A
Employee Type: Full-Time
Industry: Healthcare - Health Services
Manages Others: No
Job Type: Health Care
Req'd Education: Not Specified
Req'd Experience: At least 2 year(s)
Req'd Travel: Not Specified
Relocation Covered: Not Specified
Contact: Not Available
Phone: Not Available
Fax: Not Available
Ref ID: Not Available

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Job Description


JOB TITLE: Biller / Collector


II. POSITION SUMMARY:
Performs all functions related to the timely follow-up and collection of third party patient accounts, in accordance with State and Federal rules and regulations and home care policy and procedures.

III. KEY JOB DUTIES/RESPONSIBILITIES:

A. Reviews reports from insurance companies/government payors for possibility of resubmission. Resubmits, bills patients, or writes-off as appropriate. Files appeals on rejected services within filing deadline. Weight: 15%
B. Follows-up on unpaid third party accounts by telephone and/or tracer within time frames and guidelines set forth in home care policies and procedures. Prepares rebilling as necessary. Weight: 15%
C. Reviews correspondence received from third party carriers, etc., and responds before insurance company deadlines. Makes request for Medical Records when necessary. Weight: 15%
D. Reviews payments on accounts for accuracy. Contacts insurance carriers if payment is less than quoted benefits to resolve balance responsibility. Calculates or recalculates contractual allowances and corrects as necessary. Corrects Managed Care discounts, employee discounts, etc., as necessary after recalculating discount. Weight: 15%
E. Documents all insurance activity in patient accounting computer system. Weight: 7%
F. Performs other duties as assigned.

 
Job Requirements
IV. SUPERVISION: Controller (primary), CFO, and Director of Finance.

V. QUALIFICATIONS:
A. EDUCATION:
High School Diploma or equivalent. Must have knowledge of Commercial Insurance, Medicare, and Medicaid billing rules and regulations, as well as computer inquiry and input, and proof benefits. Must have knowledge of mathematical computations required to calculate discounts, contractual allowances, etc.


B. EXPERIENCE:
Minimum two years collection experience. This experience should include general knowledge of all product line issues in a full service home health company. Must have experience with third party billing rules and regulations and knowledge of home health PPS reimbursement issues and opportunities.

C. EQUIPMENT/SKILLS:
Requires ability to operate both a calculator and a personal computer for inquiry and input purposes. Requires typing a minimum of 35 w.p.m. Requires knowledge of mathematical computations required to calculate discounts, contractual allowances, etc. Requires good telephone skills. Requires ability to understand both written and verbal instructions.

D. WORKING CONDITIONS/PHYSICAL REQUIREMENTS:
Normal office conditions

E. OTHER:
DEXTERITY:
Requires use of hands for typing and use of calculator. Lifting of light boxes for filing.

WORKER CHARACTERISTICS:
Must be tactful and businesslike in dealings with others. Must present a neat well-groomed, professional appearance. Must be able to abide with corporation Confidentially policies. Demonstrates competence to perform assigned responsibilities in a manner that meets the age-specific and developmental needs of the member served by the department. Appropriately adapts assigned assessment, treatment, and/or service methods to accommodate the unique physical, psychosocial, cultural age-specific and other developmental needs of each member served.

Must be knowledgeable of Agency policies, procedures, and organizational structure; must adhere to the policy on Code of Ethical Behavior and our Compliance Plan; must work well with all levels of associates; must be able to remain calm in the face of irate clients; and most importantly, must DEMONSTRATE THE CORE VALUES AT ALL TIMES. Must successfully complete the pre-employment/post job offer health screening and the annual screening each year thereafter as an employee.


 
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