Accounts Receivable Insurance Follow Up Collector-Hybrid/Remote

Position Title: Accounts Receivable Collector 
Department: Fiscal Services
Reports To: Revenue Cycle Operations Manager
Supervises: N/A

Position Summary

The Accounts Receivable Collector is responsible for the comprehensive follow-up and resolution of aged healthcare accounts receivable. This includes managing payer denials, conducting detailed account reviews, and ensuring the timely and accurate resolution of outstanding balances. The position requires a strong focus on problem-solving, attention to detail, and the ability to work collaboratively with internal and external stakeholders while maintaining a high level of professionalism and compliance with confidentiality standards.

Qualifications

• Education: High School diploma or GED equivalent required.
• Experience: Minimum of one (1) year of experience in healthcare billing and collections, including working knowledge of payer requirements, insurance denials, and electronic health record systems.
• Skills:
  • Proficiency in typing (minimum 50 wpm) and data entry with high accuracy.
  • Strong organizational and time management skills.
  • Effective communication skills, both verbal and written.
  • Ability to work independently with minimal supervision.
• Technical Requirements: Familiarity with billing software, electronic claims submission, and Microsoft Office Suite.
• Physical Requirements: Ability to sit for extended periods (up to 7 hours per 8-hour shift) and to see and hear with or without correction.
• Additional Requirements: If applicable, two years of continuous, verifiable abstinence for individuals in recovery.

Essential Functions

1. Accounts Receivable Management
   • Perform follow-up on aged accounts receivable to ensure timely resolution of balances.
   • Review and analyze payer denials, identify trends, and take corrective action as needed.
   • Conduct thorough reviews of patient accounts during the follow-up process to ensure accuracy and completeness of billing.
2. Claim Submission and Monitoring
   • Submit accurate and complete claims to insurance companies within one (1) business day of creation.
   • Track and follow up on outstanding claims within 14 days of submission and at regular intervals thereafter until resolution.
3. Patient Account Management
   • Communicate with patients regarding outstanding balances and establish payment arrangements when appropriate.
   • Follow up on patient account balances within 30 days of statement mailing and regularly thereafter until resolution.
4. Documentation and Reporting
   • Maintain accurate and up-to-date collection notes in the electronic system in compliance with organizational policies.
   • Provide regular updates to the Revenue Cycle Operations Manager and other stakeholders regarding account activity and escalations.
5. Collaboration and Communication
   • Serve as a professional point of contact for internal and external stakeholders, including insurance companies, patients, and third-party vendors.
   • Escalate unresolved or complex issues to the appropriate supervisor in a timely manner.
6. Compliance and Confidentiality
   • Adhere to the provisions of 42 CFR Part 2 (Confidentiality of Alcohol and Drug Abuse Patient Records) and 45 CFR (HIPAA).
   • Ensure all credit information and patient account details remain confidential.
7. Customer Service
   • Provide courteous and professional assistance to patients, families, and payer representatives.
   • Foster positive working relationships with colleagues, managers, and external contacts.
8. Additional Duties
   • Review and recommend accounts for outside collection when necessary.
   • Participate in training and professional development activities as required.
   • Perform other duties as assigned to support the team and organizational goals.

Core Competencies

• Problem-solving and critical thinking.
• Accuracy and attention to detail.
• Knowledge of insurance billing practices and healthcare regulations.
• Ability to work in a cooperative and collaborative manner.
• Strong ethical standards and commitment to maintaining confidentiality.

Work Environment and Expectations

• Maintain regular attendance and punctuality.
• Work in a fast-paced, deadline-driven environment.
• Ability to remain alert and focused to perform duties safely and effectively.