Administrative

Collections Representative Contract NEW

Russell Tobin is looking for a Collections Representative to work for our client in Philadelphia, PA

Location: Cira Centre, 2929 Arch St, Philadelphia, PA 19104
Pay: $21 per hour 

Summary: 

Responsible for ensuring correct and timely reimbursement from third party payors for services provided by Children’s Anesthesiology Associates, Ltd. (CAA). The Collections Rep will appeal, re-bill, and perform other necessary actions to collect revenue due CAA. The Collections Rep will be involved in other AR related projects on a daily basis. The Collections Rep will employ appropriate resources to investigate, analyze, identify and reduce barriers to correct adjudication, such as issues involving Network Set-Up, Fee Schedules, Denial Management, and Contract Compliance. The primary focus of this position is to maximize reimbursements through the timely follow up of accounts.

Responsibilities:

  •  Proven working experience as a Collections/Account Receivable Rep
  •  Solid understanding of insurance follow-up, denials, reimbursements, contracts and insurance policies
  •  Investigate Accounts identified as low pays, denials, or otherwise (75%)      
  •  Review accounts in work file/queue and take appropriate steps to resolve accounts in compliance with CAA’s contracts, agreements, or appropriate measures.
  • Contact insurance company/third parties by telephone, letter, fax, e-mail, etc. as needed.
  • Include complete and appropriate comments on actions taken to resolve accounts.
  • Review and perform analysis and trending to identify possible barriers to correct and timely claim submission, claim processing, provider enrollment, among others which may result in non-payments, delayed payments, or low payments.
  • Transfer accounts when necessary and only after confirming updated registration or eligibility.
  • Ensure that all claim submissions, appeals, and requested information is provided within the required time frame to avoid timely filing issues and processing delays.
  • Properly handle all other insurance explanation of benefits that require other activities or reconciliation.
  • Request and include correct and appropriate attachments as required and in accordance with policies and procedures.
  • Assist with special projects, audits and reconciliation as necessary.
  • Reconcile credit balances and submit requests for refunds in accordance with policies or when applicable or contact Payor to initiate off-sets/retractions of incorrectly paid services when possible. (15%)
  • Investigate and submit for approval write off allowances and/or adjustments that have reasonable justification in accordance with CAA’s contracts and policies. (10%)
  •  Interact professionally and productively with Co-workers and CHOP staff in areas such as registration, Physician Billing, and Patient Access and Revenue Cycle, and others.
  • Meet minimum production and performance target goals.
  • Work correspondence daily.
  • Other duties as assigned.

Skills:    
Needs someone with min 5-7 years of insurance follow-up, AR collection, denial management for commercial and government payors. Anesthesia experience is preferred. EPIC experience is necessary.  

• Knowledge of word processing, electronic mail, and spreadsheet applications.
• Must be proficient in Microsoft Excel. Must be comfortable working with large data sets.
• Excellent analytic skills.
• Excellent interpersonal and organization skills.
• Ability to handle multiple tasks, meet deadlines and handle confidential materials.
• Excellent phone etiquette. Strong customer service and phone skills.
• Epic experience is preferred

Education:    
High school diploma or equivalent with three years experience in the medical field preferably with physician billing/collections.

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