Medical Collections Job Description

Medical Collections Job Description

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Medical collections provides anesthesia cross walk codes, procedure, diagnosis and modifier coding using CPT and ICD-10 coding systems.

Medical Collections Duties & Responsibilities

To write an effective medical collections job description, begin by listing detailed duties, responsibilities and expectations. We have included medical collections job description templates that you can modify and use.

Sample responsibilities for this position include:

Maintains a working knowledge and understanding of CPT and ICD-10 codes
Utilizes the Medicare Direct Data Entry system to identify and resolve any claims that have been Returned to Provider
Making necessary corrections to account
Entering EOB correspondence from insurance companies
Entering and following up with insurance companies request for medical records
Providing follow up on accounts until they are resolved
Reviewing and processing insurance requests for refunds
Coding issues are researched for correct reimbursement according to rules and regulations
Payments are researched as needed to insure compliance with contract terms
Performing follow up with insurance companies on unpaid insurance accounts identified through aging reports

Medical Collections Qualifications

Qualifications for a job description may include education, certification, and experience.

Licensing or Certifications for Medical Collections

List any licenses or certifications required by the position: DOT

Education for Medical Collections

Typically a job would require a certain level of education.

Employers hiring for the medical collections job most commonly would prefer for their future employee to have a relevant degree such as Associate and Bachelor's Degree in Education, Technical, Accounting, Associates, Finance, Business/Administration, Medical, Business, Medical Billing, Medical Billing and Coding

Skills for Medical Collections

Desired skills for medical collections include:

Managed care payers and medical terminology
Medicare
Basic medical terminology
Commercial
HMO/PPO
Medicaid
Tricare insurance operating procedures and contracts
HIPAA regulations and the FDCPA
CPT and ICD-10 codes
Medical coding

Desired experience for medical collections includes:

Processing appeals
Reviewing accounts for possible assignment and making recommendations to the Billing Supervisor
Performing daily backups on office computer system
Performing various collection actions including contacting patients by phone, correcting and resubmitting claims to third party payers
Checking each insurance payment is for accuracy and compliance with contract discount
Calling insurance companies regarding any discrepancy in payments if necessary

Medical Collections Examples

1

Medical Collections Job Description

Job Description Example
Our innovative and growing company is hiring for a medical collections. To join our growing team, please review the list of responsibilities and qualifications.
Responsibilities for medical collections
  • Enter EOB correspondence from insurance companies
  • Enter and follow up with insurance companies request for medical records
  • Follow up with payments from WIN Fertility
  • Provide follow up on accounts until they are resolved
  • Review and processes insurance requests for refunds
  • Perform follow up with insurance companies on unpaid insurance accounts identified through aging reports
  • Review accounts for possible assignment and makes recommendations to the Billing Supervisor
  • Perform daily backups on office computer system
  • Check each insurance payment is for accuracy and compliance with contract discount
  • Make necessary corrections to account, update patient demographic information, and review ICD and CPT codes for correctness
Qualifications for medical collections
  • Follow up with payments
  • Review and process insurance requests for refunds
  • Make necessary corrections to account, patient demographic information, and ICD and CPT codes
  • Ensure coding issues are researched for correct reimbursement according to rules and regulations
  • Identifying billing errors for corrections and resubmitting claims to insurance carriers
  • Following up on payment errors, low reimbursement, and denials
2

Medical Collections Job Description

Job Description Example
Our company is growing rapidly and is hiring for a medical collections. We appreciate you taking the time to review the list of qualifications and to apply for the position. If you don’t fill all of the qualifications, you may still be considered depending on your level of experience.
Responsibilities for medical collections
  • Calling multiple insurances on multiple phone lines
  • Updating system errors
  • Noting system
  • Researching insurance guidelines
  • Follow-up associated with the dispensing of prescription medication via telephone, Internet, and in writing
  • Perform adjustments in the system as needed
  • Pull medical records and submit to collection agency upon request through billing e-mail
  • Ensures prompt and timely payment of submitted invoices
  • Follows up on payments
  • Evaluate payments and denials received
Qualifications for medical collections
  • Initiate write-offs and adjustments as necessary
  • Keep escalation of calls to a minimum
  • Communicates collections of delinquent accounts problems and issues to department head and makes recommendations regarding changes to collections of delinquent accounts approaches, policies and procedures
  • Serves as a member of the Collection Department Team
  • Review and audits Associates’ productivity
  • Assist with Associates’ difficult accounts and workload and continually provides training to the Associates
3

Medical Collections Job Description

Job Description Example
Our growing company is looking for a medical collections. Thank you in advance for taking a look at the list of responsibilities and qualifications. We look forward to reviewing your resume.
Responsibilities for medical collections
  • Process and/or review adjustments as necessary (ie
  • Request Accounts Receivable Status Reports when a denial trend has been identified
  • Handles various business office duties that may include billing, cash posting, chart preparation, cash posting, collections, insurance verification, medical records, patient registration, scheduling and other assigned duties
  • Reviews / audits Associates’ productivity
  • Makes necessary telephone &/or written contact
  • Requests Accounts Receivable Status Reports when a denial trend has been identified
  • Check status of all claims on a bi-weekly basis after 30 days from billing
  • Respond to requests for additional information such as operative reports in a timely fashion
  • Contact patients regarding account balances
  • Follow up on all self-pay and payment plan accounts on a monthly basis
Qualifications for medical collections
  • Intermediate Microsoft Office Software knowledge
  • Energetic and detail oriented, analytical thinking skills, excellent telephone and communication skills, ambition for learning accepting new tasks, organization skills, billing system knowledge (preferred), multi-tasking, results driven, knowledge of HCPC and diagnosis coding (preferred), resourceful and knowledgeable of insurance guidelines (preferred), ability to adapt to change
  • Must have experience in the Medical industry
  • Accounting experience beneficial
  • Years’ experience in a related position working accounts receivable in a medical office, hospital, outpatient surgery center or related field with core duties related to medical insurance collections, billing, accounts receivable, A/R, collecting payments, collecting re-imbursements, or related training/certificates/diplomas
  • Years’ experience in a working accounts receivable insurance collections in a medical office, hospital, outpatient surgery center or related field with core duties related to medical insurance collections, billing, accounts receivable, A/R, collecting payments, collecting re-imbursements, or related training/certificates/diplomas
4

Medical Collections Job Description

Job Description Example
Our growing company is looking for a medical collections. Thank you in advance for taking a look at the list of responsibilities and qualifications. We look forward to reviewing your resume.
Responsibilities for medical collections
  • Provide backup support for Payment Posting Specialist
  • Review and submit claims to third party payors from patient accounting system
  • Review and correctly daily rejection/submission reports to confirm claims submission
  • Assist with monthly invoicing to guarantors for continued care
  • Collection and follow-up on outstanding accounts receivable in accordance with policies and procedures
  • Review and resolve accounts with credit balances
  • Document all collection efforts and contacts in patient accounting system
  • Inform Business Office Supervisor of any potential issues which may delay payment and/or issues with specific payors
  • Resubmit claims as necessary
  • Maintain log of any claim resubmissions, Rebill Log
Qualifications for medical collections
  • Associate's Degree in Business Administration, Accounting or Health Care Administration
  • Must be accustomed to sitting at a desk for long periods of time
  • Possess working knowledge of medical terminology and health insurance billing
  • Experience working denials and appeals
  • Experience with JDE systems is preferred
  • Generate patient statements and collection letters
5

Medical Collections Job Description

Job Description Example
Our company is looking for a medical collections. To join our growing team, please review the list of responsibilities and qualifications.
Responsibilities for medical collections
  • Medicare, Managed Care and Long Term Care (LTC) experience required
  • Located in the Monroeville Facility, this opportunity also provides free parking
  • Review patient bills for accuracy and completeness and obtain any missing information
  • The candidates for this position must be able to work in a fast paced union environment and be able to implement process improvements in a constantly changing health care environment
  • The candidate will need to be a positive role model to their teams and a advocate for employee engagement and quality measures
  • Register and update patient demographics
  • Scrub bills for appropriate ICD 10 & CPT codes and associated modifiers
  • Bill out timely filing of claims
  • Address insurance billing rejections and denials
  • Run Billing and A/R reports
Qualifications for medical collections
  • Ability to communicate and collaborate effectively with other internal external resources in order to resolve issues
  • Call center, authorize credit, or customer service experience a plus
  • Experience in a telecommunications environment is preferred but not required
  • Knowledge of Homecare Homebase HCHB is preferred but not required
  • High School diploma or GED/equivalent (college degree a plus)
  • Career and coal oriented

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