Work Schedule/Days: Day / Monday - Friday
Employment Type: Full-Time
Location: Support I
Requisition #: 57281
Meets all department collection and follow-up performance expectations. Completes assigned work in a timely fashion and reports any issues or obstacles to lead collector or patient accounts supervisor to ensure swift resolution. Identifies payor trends proactively in relation to zero payment, payment variance, billing, and denials. Works closely with other collectors and lead collectors in completing claims billing and follow-up collection activities. Completes projects as requested by patient accounts manager or patient accounts supervisor. Adheres to company and department attendance, basic work requirements, and other policies and procedures.
- High school diploma or equivalent
- No professional certifications required
- One year of experience in insurance billing or collections, with a general knowledge of hospital business office functions
- Some college
- Two years of experience in insurance billing and/or collections, with a general knowledge of hospital business office functions
- Knowledge of key Children's Healthcare of Atlanta patient accounting applications, e.g., Epic Resolute, Dentrix Dental, Clearinghouse, or comparable system
KNOWLEDGE SKILLS & ABILITIES*
- Knowledge of third-party requirements and policies, including Medicaid, Managed Care, Blue Cross Blue Shield, care management organizations, health maintenance organizations, preferred provider organizations, commercial payors, and self-pay
- Must have excellent telephone communication and customer service skills
- Excellent written and verbal communications skills
- Familiar with medical terminology, including diagnosis and procedure codes
- Must be able to meet department/individual goals
- Must be able to type 45 words per minute
- Must be able to operate personal computer-based systems, including working knowledge of word processing, spreadsheet, and billing software
- Performs daily billing of claims to third-party insurance following the guidelines of the UB04 and HCFA 1500 manual.
- Ensures that special billing needs by payor are performed to prevent denial of claims and delay in payment.
- Prepares and submits all final bill claims, secondary claims, rebills, and late charges on a daily basis, maintaining a current status.
- Performs routine follow-up on unpaid insurance claims, taking appropriate action to resolve problems causing delay in reimbursement.
- Documents all telephone and correspondent communications with third-party payors and guarantors thoroughly via online activity codes.
- Prioritizes and works proactively on accounts in assigned work queue to ensure all accounts are submitted in a timely manner.
- Complies with department workflows and routines.
- Contacts guarantors and other insured parties when additional information is needed, and takes appropriate action to resolve any delay in reimbursement.
- Works correspondence daily, including adding Medicaid eligibility to self-pay and commercial accounts.
- Works returned mail on high-dollar accounts and correspondences from third-party payors.
- Takes appropriate action to resolve all insurance, bad debt, and/or self-pay unpaid balances.
Safety: Practices proper safety techniques in accordance with hospital and departmental policies and procedures. Responsible for the reporting of employee/patient/visitor injuries or accidents, or other safety issues to the supervisor and in the occurrence notification system.
Compliance: Monitors and ensures compliance with all regulatory requirements, organizational standards, and policies and procedures related to area of responsibility. Identifies potential risk areas within area of responsibility and supports problem resolution process. Maintains records of compliance activities and reports compliance activities to the Compliance Office.
The above statements are intended to describe the general nature and level of work performed by people assigned to this classification. They are not intended to be an exhaustive list of all job duties performed by the personnel so classified.
Ability to lift up to 15 lbs independently not to exceed 50 lbs without assistance
Bending/Stooping - Occasionally (activity or condition exists up to 1/3 of time)
Climbing - Not Present
Hearing/Speaking - Effective communication with employees, supervisors/managers and staff. Effective communications with patients and visitors, as required.
Lifting - Occasionally (activity or condition exists up to 1/3 of time)
Pushing/Pulling - Occasionally (activity or condition exists up to 1/3 of time)
Sitting - Frequently (activity or condition exists from 1/3 to 2/3 of time)
Standing - Occasionally (activity or condition exists up to 1/3 of time)
Walking - Occasionally (activity or condition exists up to 1/3 of time)
No potential for exposure to blood and body fluids
Children’s Healthcare of Atlanta has been 100 percent committed to kids for more than 100 years. A not-for-profit organization, Children’s is dedicated to making kids better today and healthier tomorrow.
With 3 hospitals, 20 neighborhood locations and a total of 673 beds, Children’s is the largest healthcare provider for children in Georgia and one of the largest pediatric clinical care providers in the country. Children’s offers access to more than 60 pediatric specialties and programs and is ranked among the top children’s hospitals in the country by U.S. News & World Report.
Children’s has been recognized as a Fortune 100 Best Place to Work, a Best Place for Working Mothers, and as a top employer for diversity and millennials. We offer a comprehensive compensation and benefit package that supports our mission, vision and values. We are proud to offer an array of programs and services to our employees that have distinguished us as a best place to work in the country. Connect to our mission of making kids better today and healthier tomorrow.
Have questions about the recruitment process? Check out What to Expect.
Address: 1575 Northeast Expressway, Bldg 1, Atlanta, GA 30329
Function: Revenue Cycle - Patient Financial Services
Nearest Major Market: Atlanta
Job Segment: Medical, EMR, Medicaid, Pediatric, Healthcare