Provides medical collection services for TLRA collection units. Utilizes a strong background as a medical collection specialist to successfully resolve accounts placed with TLRA for collection. This involves performing collection activities related to follow-up and account resolution, and includes communication to patients, clients, reimbursement vendors, and other external entities while adhering to all client, state and federal guidelines. Patient and client satisfaction is essential. Associates in the collection unites are expected to knave knowledge of the overall collection work processes for the both active AR and BD inventory.
Possesses thorough understanding of the hospital revenue cycle with specialization in hospital billing, follow-up, and the account resolution process.
Utilizes and applies industry knowledge to resolve aged accounts receivable by working various account types including, but not limited to: hospital and/or professional claims, governmental and/or non-governmental claims, denied claims, high priority accounts, etc.
Manage multiple work queues for follow-up and denials by engaging payor websites and initiate calls in order to ensure prompt payment of medical claims. Pursues and/or follow-up on appeals. Initiates communication with coding team and clinical staff when coding related, and medical necessity appeals are warranted.
Identifies denial trends and notifies Supervisor and/or Manager to prevent future denials and further delay in payments. Makes recommendations for resolution.
Remains open-minded with change: maintains performance during period(s) of change and understands changes in tasks and/or environment as well as the basis for change
Possesses ability to professionally communicate (in all forms) with payer resources such as: website, e-mail, telephone, customer service departments, etc.
Possesses a cooperative and positive attitude toward clients, management, and co-workers by responding politely and professionally and being a valued team player
Ability to meet departmental standard for quality and productivity.
Must have minimum of 3 years' experience in a Customer Service call enter environment with a focus on healthcare billing/collections or collection agency environment or 3 years' experience working in a client service or marketing capacity, preferably in a healthcare or collection agency environment.
General hospital A/R accounts knowledge is required.
PC skills in a Windows environment are required. Solid knowledge and utilization of desktop applications to include Word and Excel are essential.
College education, previous Insurance Company claims experience and/or health care billing trade school education may be considered in lieu of formal hospital experience.
According to the US Bureau of Labor Statistics (BLS), employment in healthcare occupations is projected to grow 15 percent from 2019 to 2029, much faster than the average for all occupations, adding about 2.4 million new jobs. Healthcare occupations are projected to add more jobs than any of the other occupational groups. This projected growth is mainly due to an aging population, leading to greater demand for healthcare services.
Employment of registered nurses is projected to grow 7 percent from 2019 to 2029, faster than the average for all occupations. Growth will occur for a number of reasons, including an increased emphasis on preventive care; increasing rates of chronic conditions, such as diabetes and obesity; and demand for healthcare services from the baby-boom population, as this group leads longer and more active lives.
According to BLS, the median annual wage for healthcare practitioners and technical occupations (such as registered nurses, physicians and surgeons, and dental hygienists) was $69,870 in May 2020, which was higher than the median annual wage for all occupations in the economy of $41,950.
Healthcare support occupations (such as home health aides, occupational therapy assistants, and medical transcriptionists) had a median annual wage of $29,960 in May 2020, lower than the median annual wage for all occupations in the economy.
The median annual wage for registered nurses was $75,330 in May 2020.
Here are some occupations within Medical and Nursing:
Clinical Laboratory Technologists and Technicians
Diagnostic Medical Sonographers and Cardiovascular Technologists and Technicians, Including Vascular Technologists
Dietitians and Nutritionists
Licensed Practical and Licensed Vocational Nurses
Nurse Anesthetists, Nurse Midwives, and Nurse Practitioners