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51 Valley Stream Parkway
Malvern, PA 19355
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Independence Physician Management • Malvern, PA
Posted 27 days ago
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The Collections Specialist responsible for making outgoing call to IPM guarantors to collect self-pay balances for professional services provided. Audits accounts for accuracy to ensure that past due balances are patient responsibility. Triages calls in an efficient manner if insurance responsibility is identified. Answers guarantor inquiries regarding charges, insurance, and explanation of benefits (EOBs). Collects and posts payments to the Practice Management System (PMS). Establishes payment plans adhering to Central Billing Operations (CBO) policy (threshold/terms, propensity to pay scores, promissory notes) and timely follow-up to maximize collections and optimize collection return on investment (ROI). Meets or exceeds established performance targets (productivity and quality) established by the Customer Service and Patient Collections Manager. Documents each call in PMS so that notes may be reviewed by others and there is continuity in communication and overall handling of the account. Exercises good judgement in escalating complex account issues or customer dissatisfaction to the Customer Service and Patient Collections Manager. Demonstrates the ability to be an effective team player. Upholds “best practices” in day to day processes and work flow standardization to drive maximum results.Job Requirements
Conducts outgoing calls to IPM guarantors with a focus on collecting past due self-pay balances for professional services in a customer-oriented and professional manner.
Audits accounts for accuracy to ensure that past due balances are patient responsibility. Accurately answers guarantor inquiries regarding charges, insurance, and explanation of benefits (EOBs). Triages calls in an efficient manner if insurance responsibility is identified
Collects and posts payments to the Practice Management System (PMS).Establish payment plans adhering to IPM CBO policy (threshold/terms, propensity to pay scores, promissory notes) and timely follow-up to maximize collections and optimize collection return on investment (ROI).
Works with other individuals (both within the self-pay department and in other CBO departments) to obtain information needed to service the guarantor. Identifies root causes of customer barriers and/or complaints and works internally to communicate those findings to the appropriate staff.
Maintains an expanded knowledge base of state and federal regulations and company policies regarding compliance, patient privacy and ethical billing and collection practices, payment plan structures, P2P processes, negotiation in accordance with IPM collection policies and self-pay payment processing
Follows-up on missed and delayed payments on established payment plans. Accurately and timely outsourcing to collection vendor following IPM CBO policy.
Participates in regularly scheduled team meetings offering new paths, procedures and approaches to maximize opportunities for performance, process, customer service and collections improvement.
Performs other duties as assigned.
Education: High School Graduate/GED required. Technical School/2 Years College/Associates Degree preferred.
Work experience: Experience (3-5 years minimum) working in a healthcare (professional) billing, health insurance or equivalent operations work environment. Minimum 2 years medical collections experience.
Knowledge: Healthcare (professional) billing; knowledge of CPT/ICD-10 coding, government, managed care and commercial insurances, claim submission requirements, reimbursement guidelines, and denial reason codes. Patient collections; state and federal regulations regarding compliance, patient privacy and ethical billing, collection practices (including payment plans) and self-payment processing. Understanding of the revenue cycle and how the various components work together preferred.
Skills: Excellent organization skills, attention to detail, research and problem solving ability. Results oriented with a proven track record of accomplishing tasks within a high-performing team environment. Service-oriented/customer-centric. Strong computer literacy skills including proficiency in Microsoft Office.
Equipment Operated: Mainframe billing software (e.g., Cerner, Epic, IDX) experience highly desirable.