Medical Credit Analyst- AR/Claims, HLP Solutions - Plano, TX
Job Description
Medical Credit Analyst- Claims and Accounts Receivable
HLP Solutions has partnered with a large medical billing company to identify an medical collections specialist with commercial insurance experience.
SUMMARY
Job Description
Medical Credit Analyst- Claims and Accounts Receivable
HLP Solutions has partnered with a large medical billing company to identify an medical collections specialist with commercial insurance experience.
SUMMARY
- Files insurance and collects on accounts assigned in a timely and accurate manner.
- Responsible for all collection activities on identified credit balances, recoupments, and refunds.
- Responsible for knowing the law well enough to draft your own collection letters-no templates are currently being used
- Understands TDI guidelines and Texas Statute related to healthcare reimbursement and refunds.
- Understands billing requirements of commercial payors as well as Medicare and Medicaid.
- Reviews EOBs for proper reimbursement and has excellent follow-up skills on all refund requests and recoupments.
- Reviews EOB/EOMB’s for proper reimbursement
- Monitors all contracts and single patient agreements to ensure that appropriate reimbursement is received
- Obtains benefit plans when necessary to file appropriate appeals for claims that have not been paid at the appropriate rate
- Ensures that all timely filing requirements are met and claims are followed up on in a timely and appropriate manner to eliminate timely filing denials and non-payment of claims
- Understands all governmental and commercial compliance regulations related to healthcare billing and accounts receivable management
- Follows up on unpaid/unresolved account balances on a daily basis, and notates follow up response on patient accounts
- Completes re-bill request as necessary to facilitate timely and proper claims payment
- Provides insurance carriers with requested information to facilitate payment
- Prepares adjustment and write-off requests as necessary
- At least three years of experience in a health/medical billing and collection office.
- Proficient in 10 key and alpha/numeric data entry.
- Advanced knowledge in Microsoft Office Suite, specifically Word, Excel, Outlook, and general working knowledge of Internet for business use.
