Medical Collector

Mpower Health

Medical Collector

San Antonio, TX
Full Time
Paid
  • Responsibilities

    <p>This position is responsible for the resolution of A/R in a complete, accurate, and timely manner while verifying that industry rules and regulations, including, local, state, and federal regulations, regarding billing and collection practices are followed; as well as with established internal policy and procedure.</p><p><strong>Primary Responsibilities:</strong></p><ul><li>Reviews medical record documentation to identify services provided by physicians and mid-level providers as it pertains to claims that are being filed</li><li>Verifies appropriate CPT, ICD, and HCPCS codes to accurately file claims for the physician service using the medical record as supporting documentation</li><li>Performs corrections for patient registration information that includes, but is not limited to, patient demographics and insurance information</li><li>Responsible for working claim rejections in a timely manner</li><li>Receives and interprets Explanation of Benefits (EOB) that supports payments from Insurance Carriers, Able to apply correctly to claims/ fee billed</li><li>Processes incoming EOBs to ensure timely insurance filing. May require correction of data originally submitted for a claim or Coordination of Benefits with secondary insurance</li><li>Responsible for processing payments, adjustments, and denials according to established guidelines</li><li>Responsible for reviewing insurance payer reimbursements for correct contractual allowable amounts</li><li>Responsible for reconciling transactions to ensure that payments are balanced</li><li>Responsible for reducing accounts receivables by accurately and thoroughly working assigned accounts in accordance with established policy and procedures</li><li>Responsible for keeping current with changes in their respective payer’s policies and procedures</li></ul><p><strong>Required Qualifications:</strong></p><ul><li>High school diploma or GED equivalent</li><li>Two or more years of relevant experience in the healthcare industry, with a focus on medical terminology and ICD/CPT coding preferred</li><li>Strong attention to detail and professional customer service skills</li><li>Intermediate level with Microsoft Office applications</li></ul><p><strong>Preferred Qualifications:</strong></p><ul><li>Knowledge of submission and resubmission of medical claims</li><li>Government and commercial policies and procedures knowledge.</li><li>Knowledge of ICD, CPT codes and HCPCS coding</li><li>HIPAA compliance rules and regulations</li><li>Skill in the operation of billing software and office equipment</li><li>Skill in processing claims efficiently and on a timely basis</li><li>Superior interpersonal and problem-solving skills along with a high initiative to succeed</li></ul><p>IND123</p>