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The Central Business Office is seeking a Medical Collector. The position coordinates the functions of Collections and Customer Service on individual patient account. The incumbent will have specific knowledge on Managed Care, PPO or Commercial accounts and use this information to ensure patient demographic information is accurate, and funding source is billed and collected appropriately, accurately and timely.
Accountabilities (For Non-exempt Employees Include Percent of Effort):
Make and receive phone calls from patients and insurance companies 20%
regarding accounts. Respond to all requests for information or clarification necessary for the payment of outstanding accounts.
Review Accounts Receivable Trial Balances and identify unpaid or underpaid 20%
claims: determine reason(s) for balance and take appropriate steps to contact
appropriate party to resolve payment issue(s). Maintain tickler file of outstanding
accounts (Rep file/Alert Manager) to include telephone notes based on work to
resolve outstanding issues. Keep accurate notes of all activity
Advise Supervisor/manager on trends of payment and problems 12%
as seen by doing reconciliation of logs with payer.
Prepare adjustment forms as needed to correct accounts and submit these forms 10%
to supervisor/manager
Participate in the resolution of complex billing questions and inquiries; 10%
as well as perform/act as knowledgeable resource for staff related to data
integrity, application of plan benefits to patient accounts, and compliance
with payer specific, state and federal rules and requirements. Inform
Supervisor/Team Lead/Manager of payment discrepancies; and ensures
that all payer reason codes, remark codes, payer correspondence are posted
timely and accurately;
7. Bill or rebill accounts in order to finalize accounts. 3%
8. Solves issues with the payers; debit and credit balances; and respond to all 10%
requests for information or clarification necessary for the payment of
outstanding accounts
8. Meets or exceed established key performance standards 10%
Participate in special assignments/projects as directed by the Supervisor; 5%
and perform other duties as assigned
This list of duties and responsibilities is not intended to be all-inclusive and may be expanded to include other duties or responsibilities as necessary.
Supervision Received:
Report to the Non-Government Collections Supervisor
Minimum Qualifications (Essential Requirements):
High school graduate with relevant and effective work experience. Minimum one year of patient-related clerical experience in a medical setting, including understanding of medical center and medical collection. Knowledge of Managed Care, PPO, UB04, medical terminology, CPT4 codes, ICD9 codes, technical job knowledge, and Third-Party payer requirements and reimbursement rules. Knowledge of contracts that are in force for hospital, physicians, and rules and guidelines that govern collection activities required. Must have computer skills and experience in Excel.
The University of Miami offers competitive salaries and a comprehensive benefits package including medical, dental, tuition remission and more.
UHealth-University of Miami Health System, South Florida's only university-based health system, provides leading-edge patient care powered by the ground breaking research and medical education at the Miller School of Medicine. As an academic medical center, we are proud to serve South Florida, Latin America and the Caribbean. Our physicians represent more than 100 specialties and sub-specialties, and have more than one million patient encounters each year. Our tradition of excellence has earned worldwide recognition for outstanding teaching, research and patient care. We're the challenge you've been looking for.
The University of Miami is an Equal Opportunity Employer - Females/Minorities/Protected Veterans/Individuals with Disabilities are encouraged to apply. Applicants and employees are protected from discrimination based on certain categories protected by Federal law. Click here for additional information.
Job Status:
Full time
Employee Type:
Staff
Pay Grade:
H3
University of Miami
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University of Miami
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University of Miami
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