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COLLECTION SPECIALIST/3RD PARTY

Company: Presbyterian Hospital (Albuquerque, N.M.)
Location: Albuquerque
Posted on: November 18, 2021

Job Description:

Type of Opportunity: Full Time FTE: 1.000000 Exempt: No Work Schedule: Days Summary: 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. 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 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 Benefits Benefits are effective day-one (for .45 FTE and above) and include:

  • Competitive salaries
  • Full medical, dental and vision insurance
  • Flexible spending accounts (FSAs)
  • Free wellness programs
  • Paid time off (PTO)
  • Retirement plans, including matching employer contributions
  • Continuing education and career development opportunities
  • Life insurance and short/long term disability programs About Us Presbyterian Healthcare Services is a locally owned, not-for-profit healthcare system ofnine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, it is the state's largest private employer with approximately 11,000 employees. Presbyterian's story is really the story of the remarkable people who have chosen to work here. Starting with Reverend Cooper who began our journey in 1908, the hard work of thousands of physicians, employees, board members, and other volunteers brought Presbyterian from a tiny tuberculosis sanatorium to a statewide healthcare system, serving more than 700,000 New Mexicans. 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's unique blend of Spanish, Mexican and Native American influences contribute to a culturally rich lifestyle. Add in Albuquerque's International Balloon Fiesta, Los Alamos' nuclear scientists, Roswell's visitors from outer space, and Santa Fe's artists, and you get an eclectic mix of people, places and experiences that make this state great. Cities in New Mexico are continually ranked among the nation's best places to work and live by Forbes magazine, Kiplinger's Personal Finance, and other corporate and government relocation managers like Worldwide ERC. 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.

Keywords: Presbyterian Hospital (Albuquerque, N.M.), Albuquerque , COLLECTION SPECIALIST/3RD PARTY, Accounting, Auditing , Albuquerque, New Mexico

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