Job Summary

Under general supervision, performs accounts receivable follow up /collections to obtain timely reimbursement from third party carriers and other payment sources on Ambulatory Surgery Center surgical cases. Maintains contacts with payers and communicates billing/reimbursement issues to management in a timely manner. Evaluate A/R and participate in development of collection strategies to decrease outstanding A/R.

Minimum Qualifications

Education/Training:

High school graduation or equivalent.  Bachelor’s or Associate’s degree preferred. Consideration will be given to an appropriate combination of education/training and experience.

Experience:

2 years related A/R experience. Surgery Center billing preferred.

License/Cert/Reg:

No special certification, registration or licensure required.

Knowledge, Skills & Abilities:

Verbal and written communication skills.  Basic computer skills preferred. Knowledge of carrier EOBs (explanation of benefits) required as well as basic medical terminology and CPT/ICD-10 coding.  Requires ability to work in Microsoft Word and Excel applications.

Primary Duties and Responsibilities

1. Contributes to the achievement of established department goals and objectives and adheres to department policies, procedures, quality standards, and safety standards. Complies with governmental and accreditation regulations.
2. Meets assigned benchmark quotas as determined by management.
3. Reviews all outstanding A/R cases each month, with the goal of only touching each account once.
4. Meets monthly departmental key performance indicators (KPIs) as it applies to open receivables, aged A/R, credit balances, and high dollar accounts.
5. Keeps abreast of regulatory and specific changes as it relates to billing requirements and payer specific follow up communicating such changes to management timely.
6. Completes and works daily any correspondence received in the mail or through the lockbox.
7. Enters comments in the billing system for each account worked detailing any work completed or notes for follow up.
8. Participates in team meetings providing any pertinent updates or information required for the department.
9. Works and maintains all outstanding accounts and their status which is then provided to management daily.
10. Daily meetings with management to communicate any needs or resources that are required for successfully completion of tasks.
11. Participates in meetings and on committees and represents the department and hospital in community outreach efforts.
12. Participates in multi-disciplinary quality and service improvement teams.
13. Performs other duties as assigned.