On behalf of Johns Hopkins University, we are seeking a a full time Collections Specialist. The Collections Specialist will be responsible for the collection of unpaid third-party claims and appeals, using various applications of JHM and JHU/ PBS billing applications.
- Uses A/R follow-up systems and reports to identify unpaid claims for collection/appeal.
- Gathers and verifies all information required to produce a clean claim including special billing procedures that may be defined by a payer or contract.
- Review and update patient registration information (demographic and insurance) as needed.
- Applies appropriate discounts / courtesies based on department policy.
- Prepares delinquent accounts for transfer to self-pay collection unit according to the follow-up matrix.
- Prints and mails claim forms and statements according to the follow-up matrix.
- Retrieves supporting documents (medical reports, authorizations, etc) as needed and submits to third-party payers.
- Appeals reflected claims and claims with low reimbursement.
- Confirm credit balances and gathers necessary documentation for processing refund.
- Identifies insurance issues of primary vs. secondary insurance, coordination of benefits eligibility and any other issue causing non-payment of claims.
- Contacts the payors or patient as appropriate for corrective action to resolve the issue and receive payment of claims.
- Monitor invoice activity until problem is resolved.
- Process daily mail, edits reports, file or pull EOB batches.
- Identifies and informs the supervisor / Production Unit Manager of issues or problems associated with non-payment of claims.
Working hours: 8:00 AM - 5:00 PM
- One year experience in a medical billing or similar specialty environment required.
- Knowledge of medical terminology, CPT codes and diagnosis coding required.
- Excellent interpersonal, communication and customer service skills required.
- Ability to use various billing and patient information computer systems preferred.
- Knowledge of various payer processing and submission guidelines preferred.
- Must possess high school diploma or GED
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