Collection Specialist will follow-up with insurance companies to collect outstanding accounts for which payment has not been received in response to the claims submission process, either electronically or by paper. The Specialist will be assigned payer groups of outstanding patient accounts. Various methods of follow-up will be used including the PCS System of IDX. The specialist must have expertise in insurance follow-up processing and be knowledgeable in CPT and ICD-9-CM coding as well as have an understanding of the JHOC registration process and be able to recognize and resolve incorrect demographic and insurance registration. The Specialist must have an understanding of claims submission requirements for all payers to expedite payments as well as knowledge of appeals and rejections processing. This person must have excellent communication skills coupled with patience and fortitude.
Identifies problem issues on outstanding patient accounts. Works to resolve issues so that invoice will be processed by payor or balance moved to patient responsibility.
Identifies insurance issues of primary vs secondary insurance, coordination of benefits, Eligibility and any other issue causing non-payment of claims. Contacts the payer or Patient as appropriate for corrective action to resolve the issue and receive payment of Claims.
Alerts the manager to problems with specific carrier payments, improper rejections or Non-compliance with Maryland law when the issue cannoli be resolved or if there seems to be a trend with a particular payer.
Handles patient account inquiries and assists patients with filing or re-filing of claims including secondary insurance.
Communicates with patients, physicians and insurance companies to resolve accounts. This includes resolving issues identified through incoming correspondence.
Works system collection reports and works files such as: aged trial balances, data Searches, paperless collection system (PCS).
Print and mail/fax claim forms and statements as requested by patients, insurance companies or other authorized third parties.
Confirm credit balances and gather necessary documentation for processing refund.
Prints medical notes from the EPR system when needed for the processing of claims.
Working knowledge of the IDX billing and EPIC registration systems.
Requires high school diploma/GED, and a minimum of one (1) year of experience in medical billing or demonstrated knowledge of medical billing concepts.
Additional education may substitute for required experience and additional related experience may substitute for required education, to the extent permitted by the JHU equivalency formula
JHU Equivalency Formula: 30 undergraduate degree credits (semester hours) or 18 graduate degree credits may substitute for one year of experience. Additional related experience may substitute for required education on the same basis. For jobs where equivalency is permitted, up to two years of non-related college course work may be applied towards the total minimum education/experience required for the respective job.
Starting Salary Range: $12.97-$17.87; commensurate with experience
Employee Group: Full-Time
Schedule: M-F; 40 hrs./wk.
Employee Subgroup: Non-Exempt
Department Name: Radiology
Personnel area: School of Medicine
The successful candidate(s) for this position will be subject to a pre-employment background check.
If you are interested in applying for employment with The Johns Hopkins University and require special assistance or accommodation during any part of the pre-employment process, please contact the HR Business Services Office at firstname.lastname@example.org. For TTY users, call via Maryland Relay or dial 711.
The following additional provisions may apply depending on which campus you will work. Your recruiter will advise accordingly.
During the Influenza ("the flu") season, as a condition of employment, The Johns Hopkins Institutions require all employees who provide ongoing services to patients or work in patient care or clinical care areas to have an annual influenza vaccination or possess an approved medical or religious exception. Failure to meet this requirement may result in termination of employment.
The pre-employment physical for positions in clinical areas, laboratories, working with research subjects, or involving community contact requires documentation of immune status against Rubella (German measles), Rubeola (Measles), Mumps, Varicella (chickenpox), Hepatitis B and documentation of having received the Tdap (Tetanus, diphtheria, pertussis) vaccination. This may include documentation of having two (2) MMR vaccines; two (2) Varicella vaccines; or antibody status to these diseases from laboratory testing. Blood tests for immunities to these diseases are ordinarily included in the pre-employment physical exam except for those employees who provide results of blood tests or immunization documentation from their own health care providers. Any vaccinations required for these diseases will be given at no cost in our Occupational Health office.
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