Insurance Collector

• Review and analyze insurance claims with accounts receivable balances that have aged beyond 30 days old or claims denied in the Insurance Follow-Up Module and A/R reports.

• Make use of all available tools (websites, clearinghouse, EMR and PM Systems) to efficiently identify reasons for non-payments and follow the steps needed for the insurance to adjudicate the claims.

• Review and work the claims on Hold due to rejections.

• Follow up on claims over 30 days old to identify the reason for non-payment and contact the insurance to adjudicate/pay the claims.

• Gather and submit necessary medical documentation (History and Physicals, Letters of Medical Necessity, etc.) so the payers can adjudicate the claims.

• Document Notes (Notes, Alert, FinNotes) in the patient accounts/claims to record steps taken to adjudicate the claims and collect balances and to document conversations with insurance/patients.

• Maintain documentation of all follow-up/collection activities including, but not limited to e-mails, requests to write off accounts and approvals in the designated drives.

• Identify the trends in denials by running and reviewing monthly payment and denial reason reports.

• Post denial write offs per the EOB or as approved by management.

• Focus on the patient/Insurance requests by following through on them until they are resolved to the patients’ satisfaction and within the insurance guidelines.

• Document issues and follow up on responses from all the teams in a timely manner.