Collection Rep II

Req#: R22090
Category(s): Finance, Accounts Receivable
Full Time / Part Time: Full-Time
Shift: First

Summary: 

Collection Representatives play an important role in the financial success of the hospitals. The duties include but are not limited to efficient resolution of hospital third party claims and patient balances. A Collection Representative collaborates with other areas of the Revenue Cycle including Access Services, Health Information Management, other areas of Patient Accounting, the numerous service areas and insurance companies to achieve claim resolution. A successful Collection Representative will build relationships with our customers, both internal and external, to promote feed back and timely resolution of outstanding claims. The Collection Representative will need to be proficient in many softwares being utilized throughout the Revenue Cycle as well as the various Health Insurance web sites. Additionally, a Collection Representative must understand the various insurance payment methodologies to insure accurate reimbursement.

Job Responsibilities: 

1) Maintain current knowledge of all third party requirements including managed care contracts and state and government regulations, to ensure compliance. Establish and maintain relationships with third party representatives to promote feedback and timely resolution of claims..

2) Obtain supporting documentation and other information required to insure acceptance of claim by third party payer.

3) Using skills and techniques, interact with third party payers and patients for resolution of outstanding balances.

4) Process claim form electronically or manually according to payer specifications, as needed.

5) Update billing information via on-line billing systems, as needed. Document pertinent account information pertaining to claims submission and resolution.

6) Maintain or exceed department specific productivity and quality measurements

7) Use multiple insurers web sites to assist with claims resolution, eligibility, referrals, authorizations, and other needs as identified.

8) Interact and communicate effectively with inter-departmental units when necessary.

9) Assist in Identification and Resolution of Payment Barriers and Systems Issues.

10) Participate in Education, Training and Cross-training activities as needed.

Required Work Experience: 

1) One year Hospital Medical Billing and/or Collection experience required,

Preferred Work Experience: 

1) two or more years experience preferred

Skills and Competencies: 

1) excellent PC skills required

2)  Good oral and written communication skills

3)  Ability to work with patients and staff in a professional and efficient manner to resolve issues

4)  Able to work independently

You Belong At Baystate

At Baystate Health we know that treating one another with dignity and equity is what elevates respect for our patients and staff. It makes us not just an organization, but also a community where you belong. It is how we advance the care and enhance the lives of all people.

DIVERSE TEAMS. DIVERSE PATIENTS. DIVERSE LOCATIONS.

Education:

GED or HiSET (Required)

Certifications:

Equal Employment Opportunity Employer

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