Insurance Collection Rep III

Rochester, NY

GENERAL PURPOSE:

Responsible for resolving aged insurance accounts which have not been collected through billing & routine follow-up activities. Assesses payment probability to determine appropriate collection techniques. Assists & works with patients, payers, providers and various depts to resolve issues and process unresolved claims for reimbursement.

RESPONSIBILITIES:

  • Resolves unpaid insurance accounts, including denials, within a timely period and that are impeding the prompt resolution/collection of AIR. Contacts are via correspondence, telephone, websites or meeting with payer representatives. Monitors A/R on a daily basis and keeps accounts current.

  • If unable to resolve insurance problem with third-party insurance for any reason (lack of cooperation, etc.): researches, identifies and contributes to resolution, collaborates with internal departments, Lead, Managers and/or files appeals as needed for resolution.

  • Documents all actions for both patient and University personnel and interacts with ancillary areas to secure needed assistance/documentation to meet insurers requirements. If NR is deemed uncollectable, with the supervision/approval of managers, performs

  • adjustments on accounts as necessary to maintain accurate AIR balances.

  • Maintains a detailed knowledge of insurance regulations, compliance guidelines and billing procedures which affect NR, so as to rebill and appeal claims accurately and timely. Responds to written and verbal payer and ancillary questions timely and accurately. Researches questions using a variety of tools provided, including payer websites and managers as needed. Maintains records for effective reporting. Documents and/or scans all pertinent information in patient record per departmental guidelines

  • Other duties as assigned.

QUALIFICATIONS:

  • 1 year of patient accounting/billing or consumer collections experience, or certification obtained from a nationally accredited billing program (i.e., Certified Medical Billing Specialist CMBS, Certified Medical Records Technician CMRT, Certified Medical Reimbursement Specialist CMRS); or an equivalent combination of education and experience preferred.

  • Or equivalent combination of education and experience required.

  • Knowledge of CDT, CPT and ICD JO codes.Some experience with excel and WORD as well as knowledge in on-line communication skills, proven organizational skills and ability to multi-task preferred.

  • Experience, or certification obtained from a nationally accredited billing program (i.e., Certified Medical Billing Specialist CMBS, Certified Medical Records Technician CMRT, Certified Medical Reimbursement Specialist CMRS); or an equivalent preferred but not required.

How To Apply

All applicants must apply online.

EOE Minorities/Females/Protected Veterans/Disabled

Pay Range

Pay Range: $ 19.37 - $ 27.12 Hourly

The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job’s compensation range, and will be determined by considering factors including, but not limited to, market data, education, experience, qualifications, expertise of the individual, and internal equity considerations.

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