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Managed Care Collector
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Managed Care Collector

Job Description

Our Central Business Office is growing dramatically and we are currently looking to onboard 4 Managed Care Collectors as soon as possible!! These positions provide lots of room for growth and upward mobility within the company. We will be looking to open up at least three more hospitals before the end of the year and will definitely be continuing to grow. Please feel free to reach out regarding any further inquiries. Strong opportunities to grow individually and advance within a growing organization.

 

Job Responsibilities:

 

Thorough understanding of the revenue cycle process, from patient access (authorization, admissions) through Patient Financial Services (billing, collections) procedures and policies
•Intermediate skill in  Microsoft Office (Word, Excel)
•Ability to learn hospital systems: PARAGON, PCON, PATCOM, EPREMIS, HPF quickly and fluently-Ability to work well between two different systems without any issues
•Ability to communicate in a clear and professional manner
•Retroactive Denial Payments
•Contracts: Late Penalties- how many days you have to close accounts within 90 day period
• 90 day filing before appeals
•Hospital Compensation percentages/percentages getting paid
•Has a full understanding of the  Managed Care collections, Intermediate knowledge of Manage Care contracts, Contract Language and Federal and State requirements.
•Familiar with terms such as HMO, PPO, IPA and Capitation and how these payors process claims.
•Intermediate understanding of  EOB
•Intermediate understanding of  Hospital billing form requirements ( UB04) and familiar with the HCFA 1500 forms.
•Ability to problem solve, prioritize duties and follow-through completely with assigned tasks.
-Ability to collect 40 ACCOUNTS per day
-Familiar with contract rates: How to calculate expected reimbursement/familiar with reimbursement methodologies
-High dollar/stop loss experience: Familiar with contracts because there is a cap and you need to collect after
-How to read contractual agreements between Hospital and Provider
-Familiarity with DRG Rates and CMS DRG Calculations
-Familiar with what “ LOS" stands for: (Length of Stay)

Job Requirements

The job qualifcations include:
  • High School Diploma or equivalent
  • At least 2 years of experience within Hospital Collections   
  • Microsoft Office experience (Excel, Word, Outlook, Powerpoint)
  • Familiarity with Managed Care Insurance   
  • Can work independently with minimal Supervision
  • Is professional and always on point
  • Does not have problems/issues with meeting department quotas/deadlines
  • Proven successful Track Record

Job Snapshot

Base Pay $18.00 /Hour
Employment Type Full-Time
Job Type Health Care
Education High School
Experience At least 2 year(s)
Manages Others Not Specified
Industry Healthcare - Health Services
Required Travel None
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Managed Care Collector


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