Job details

Collection Specialist Representative

Overview:

Follows-up, collects, and resolves all outstanding accounts receivable. Performs a variety of duties including accounts receivable follow-up, customer service, correspondence response, and daily reconciliation of activities. Meets established guidelines to ensure timely and accurate reimbursement for all billed charges

Type of Opportunity: Full Time
FTE: 1.000000
Exempt: No
Work Schedule: Days

Qualifications:

High School degree or GED is required, short-term training on insurance collections and claims processing. Minimum six months experience in insurance follow-up. One year of similar medical facility, physicians office or experience with major carrier in claims processing preferred. Demonstrated ability to communicate effectively via telephone and in writing. Computer literate. Must be able to work closely with coworkers

Education:
Essential:

High School Diploma or GED

Responsibilities:

Performs accounts receivable follow-up activities for their assigned payers/accounts using monthly aged account work queues and/or A/R reports.

Responsible for identifying and documenting insurance payor issues as they arise. Must communicate all issues to teammates and Follow-up & Collection Supervisor. Responsible for maintaining a file containing all pertinent information for each issue to include correspondence, EOBs, claims, etc.

Must be an effective team member with good communication skills. Must participate in team meetings, communicate work related ideas and concerns proactively, and assist in finding appropriate resolutions.

Responsible for contacting insurance companies, patients, and employers regarding outstanding hospital claims. Responsible for providing any information (medical records, itemized statements, etc) requested by insurance companies to process claims. Must maintain a system to ensure timely follow up is completed for each outstanding claim.

Maintain collection reports consisting of outstanding accounts assigned. Must work and document report according to Patient Accounting Department policies and procedures. Responsible for following up on all accounts listed on the report until resolved.

Refer accounts, in accordance with PHS guidelines, to Follow-up & Collection Manager for write-off, agency, or attorney referral. Refer difficult claims to Collection Supervisor or Manager for advice and/or assistance.

Must work closely with all outside agencies contracted with the Patient Accounting Department and assist them with account resolution for any accounts assigned to them by the Follow-up & Collection Supervisor/Manager.

Cross train in the various Patient Accounting Department areas to be completely familiar with all aspects of patient accounting functions as they relate to collections.

Adhere to all PHS and Patient Accounting Department policies and procedures to promote a smooth working environment, and uphold the PHS vision by practicing the CARES behaviors at all times.

Perform other duties as assigned by the Follow-up & Collection Supervisor and/or Manager.

Works bundled episode accounts and adds modifier in Charge Review WQs

Benefits:

We offer more than the standard benefits!
Presbyterian employees gain access to a robust wellness program, including free access to our on-site and community-based gyms, nutrition coaching and classes, wellness challenges and more!

Learn more about our employee benefits:
https://www.phs.org/careers/employee-benefits/Pages/default.aspx

Why work at Presbyterian?
As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans. For our employees, we offer a robust wellness program, including free access to our on-site and community-based gyms, nutrition coaching and classes, wellness challenges and more.

Presbyterian's story is really the story of the remarkable people who choose to work here. The hard work of our physicians, nurses, employees, board members and volunteers grew Presbyterian from a tiny tuberculosis sanatorium to a statewide healthcare system that serves more than 875,000 New Mexicans.

About Presbyterian Healthcare Services
Presbyterian Healthcare Services exists to improve the health of patients, members and the communities we serve. We are a locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1,600 providers and nearly 4,700 nurses.

Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.

About Our Regional Delivery System
Presbyterian's Regional Delivery System is a network of six hospitals and medical centers throughout rural New Mexico including locations in Clovis, Espanola, Ruidoso, Santa Fe, Socorro and Tucumcari. Our regional facilities are home to more than 1,600 clinical and non-clinical employees who help make Presbyterian the state's largest private employer with nearly 14,000 statewide employees. With a variety of services ranging from general surgery to pediatrics to heart and cancer care, our regional employees are proud to provide close-to-home care for their communities.

We are part of New Mexico's history - and committed to its future. That is why we will continue to work just as hard and care just as deeply to serve New Mexico for years to come.

About New Mexico
New Mexico continues to grow steadily in population and features a low cost-of living.

Varied landscapes bring filmmakers here from around the world to capture a slice of the natural beauty New Mexicans enjoy every day. Our landscapes are as diverse as our culture - from mountains, forests, canyons, and lakes, to caverns, hot springs and sand dunes.

New Mexico offers endless recreational opportunities to explore and enjoy an active lifestyle. Venture off the beaten path, challenge your body in the elements, or open yourself up to the expansive sky. From hiking, golfing and biking to skiing, snowboarding and boating, it's all available among our beautiful wonders of the west.

AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.

Offer Disclaimer: The compensation range for this role takes into account a wide range of factors, including but not limited to experience and training, internal equity, and other business and organizational needs. Compensation decisions are dependent upon the facts and circumstances of each offer. Minimum Offer: USD $15.18/Hr. Maximum Offer: USD $21.90/Hr.