Duties:
Position Summary: The Collector serves as the account representati ve for Hoag in working with insurance companies,government payors, and/or patients for resolution of payments and accounts resolution. Completes assigned accounts within assigned work queues. Obtains the maximum amount of reimbursement by evaluating claims at the contract rate with the use of the contract management tool for proper pricing (Examples: APC, DRG, APRDRG). Reviews and initiates the initial appeal for underpayments observing all timely requirements to secure reimbursement due to Hoag. Reviews and completes payor and/or patient correspondence in a timely manner. Escalates to the payor and/or patient accounts that need to be appealed due to improper billing, coding and/or underpayments. Reports new/unknown billing edits to direct supervisor for review and resolution. Has a strong understanding of the Revenue Cycle processes, from Patient Access (authorizations admissions) through Patient Financial Services (billing & collections), including procedures and policies. Has thorough knowledge of managed care contracts, current payor rates, understanding of terms and conditions, as well as Federal and State requirements. Interprets Explanation of Benefits (EOBs) and Electronic Admitt ance Advices (ERAs) to ensure proper payment as well asassist and educate patients and colleagues with understanding of benefit plans. Understanding of hospital billing form requirements (UB04) and familiar with the HCFA 1500 forms. Knowledge ofHMO, POS, PPO, EPO, IPA, Medicare Advantage, Covered California (Exchange), capitation,commercial and government payors (i.e. Medicare, Medi-Cal, TriCare, etc) and how these payors process claims. Demonstrates knowledge of and effectively uses patient accounting systems. Documents all calls and actions taken in the appropriate systems. Accurately codes insurance plan codes. Establishes a payment arrangement when patients are unable to pay in full at the time payment is due. May review for applicable cash rates, special rates, applicable professional and employee discounts. May process bankruptcy and deceased patient accounts. Performs other duties as assigned.
A growing agricultural operation in Eastern NY is seeking a Farm Manager to oversee daily operations across both row crops and vegetable production. The ideal candidate is experienced and knowledgeable in both conventional and organic production systems . This role is...
...Company Driver | Flatbed Location: Fred, TX Company: MK Trucking Pay: $0.63 to $0.70 per mile Route Type: otr, regional Start Date: ASAP About the Position OTR Flatbed Driver Join MK-Trucking and drive with a company that keeps you moving...
...Year-round work Family-oriented culture Health benefits Company uniforms High-quality equipment and tools As a Concrete Coating Installer, you'll prepare concrete surfaces, install high-performance coating systems, and deliver an exceptional experience...
...Part-time E-Commerce Web Developer ContractorFor almost 50 years, San Antonio Shoemakers, a San Antonio-based company, has developed a reputation as a premier American manufacturer of high quality comfort footwear. This position will report to the Director of IT and work...
North Alabama Medical Center in Florence, AL seeks a Registered Nurse to deliver compassionate, evidence-based care in a fast-paced acute care setting. The RN will assess, plan, implement, and evaluate patient care, administer medications, and coordinate with physicians...