RESPONSIBILITIES:
Collector Level I
- Demonstrates proficiency and accuracy in operating systems directly related to specific job function.
- Initiates contact with insurance carriers regarding status on claims.
- Maintains accurate and complete collection notes concerning collection activities on all accounts according to company procedures and requirements.
- Can work independently.
- Takes incoming calls from insurance carriers and patients.
- Contributes to team effort by accomplishing related results as needed.
- Ensures that all processing and reporting deadlines are consistently achieved.
- Maintain compliance with all company policies and procedures.
- Regular attendance and punctuality.
- Performs any other function as required by management.
Key Results:
- Represents company and team in a professional and positive manner.
- Meet and exceed daily and monthly production goal.
- Effective communications with staff and management.
- Demonstrates basic understanding of billing system; able to complete basic tasks based on job function.
- Adapts to changing business needs, conditions, work responsibilities.
- Able to toggle between computer screens.
- Exhibit competency in the utilization of computers, telephones, calculators, fax machines and devices-level of competency 90%.
Collector Level II
- Follow work list prioritization of accounts as established by department policies and procedures.
- Responsible for all aspects of follow up on accounts, including contacting payers and patients when necessary and accessing payer websites.
- Accurately document accounts collection notes.
- Responsible for processing appeals and researching of claims.
- Follow specific payer guidelines for appeals submission.
- Prioritize and manage accounts to resolve high priority-high dollar accounts and aging.
- Complete AR adjustments where appropriate.
- Demonstrates knowledge of government payers guidelines (Medicare/Medicaid).
- Comply with adhere to all regulatory compliance areas, policies, and procedures (including HIPPAA and PCI compliance requirements).
- Regular attendance and punctuality.
- Performs any other function as required by management.
Key Results:
- Represents Company and team in a professional and positive manner.
- Meet and exceed daily and monthly production goal.
- Effective communications with staff and management.
- Demonstrates basic understanding of billing system; able to complete basic tasks based on job function.
- Adapts to changing business needs, conditions, work responsibilities.
- Able to toggle between computer screens.
- Exhibit competency in the utilization of computers, telephones, calculators, fax machines and devices-level of competency 90%.
- Working Denials in a timely manner that results in cash collection goals.
- Detailed oriented, careful and with a focus on quality in accomplishing tasks.
- Issues identified and resolved within an average of 48 hours.
Level III
- Research and resolve payment discrepancies.
- Review and manage the AR aging report and provide explanations of past due balances to management.
- Work aged accounts on assigned payers prioritizing accounts that are approaching timely filing denial.
- Identify issues or trends with accounts and provide suggestions for resolutions.
- Escalate exhausted appeals efforts for resolution with payer.
- Performs assigned Revenue Cycle duties as directed by the Revenue Cycle Supervisor.
- Able to submit a root cause analysis report.
- Prepare write off requests as needed for any uncollectable balances.
- Keeps supervisor informed of areas of concern and problems identified.
- Provide training to new and existing staff members as instructed by supervisor. Use and follow company procedures in training. Quality check work to ensure accuracy, efficiency and uniformity. Re-train staff as often as needed.
- Ensure staff complete all assigned tasks in a timely manner and that they have the resources and tools to perform their jobs. i.e. access to software. Advise supervisor immediately if they do not.
- Review/knowledge of contracts to determine correct reimbursement for each account.
- Analyze and document A/R problems and implement processes to enhance efficiencies.
- Documenting accurate and appropriate notes on corresponding systems as needed.
- Outgoing correspondence (internal or external) must be written in a clear, concise, and professional manner.
- Provide coverage as needed to include performing staff's work during their absences as assigned by management. Assist in areas of needs as assigned by supervisor.
- Maintains positive and regular results-oriented communication with payer representatives.
- Navigate and works all payer websites. Provide support to staff as needed.
- Enroll in payer newsletters and advise manager of needs.
- Initiate appeals to payers following the guidelines outlined for that payer. Note account and track appeal to resolution.
- Utilizes strong communication and customer service skills.
- Consistently practices good judgment and problem-solving skills when handling confidential information.
- Regular attendance and punctuality.
Key Results:
- Working Denials in a timely manner that results in cash collection goals.
- Represent company and team in a professional and positive manner.
- Meet and exceed daily and monthly productivity goals.
- Detailed oriented, careful and with a focus on quality in accomplishing tasks.
- Able to toggle between computer screens
- Issues identified and resolved within an average of 48 hours.
- Adapts to changing business needs, conditions, and work responsibilities.
- Effective communications with staff and management.
- Always maintain confidentiality.
- Present ideas for improvements and strategies to meet goals. Offer viable solutions to problems.
- Promote teamwork, remaining available to assist staff as needed.
- Performs any other function as required by management.
- Report to manager any non-compliance with staff as observed by you.
- Participate in personal development training and cross training as instructed by management.
BASIC QUALIFICATIONS | EDUCATION:
- High school diploma or GED required
- Associate degree preferred
- Preferred years of experience - Level one representative 1 to 3, Level two representative 3 to 5 and Level three 5+.
- Excellent verbal and written communication skills, including ability to effectively communicate with internal and external customers.
- Excellent computer proficiency (MS Office - Word, Excel and Outlook)
- Must be able to work under pressure and meet deadlines, while maintaining a positive attitude and providing exemplary customer service
- Ability to work independently and to carry out assignments to completion within parameters of instructions given, prescribed routines, and standard accepted practices
COMPETENCIES:
Behavioral Standards:
- Exhibits customer and service-oriented behaviors in every day work interactions.
- Demonstrates a courteous and respectful attitude to internal workforce and external customers.
- Treat others with unconditional respect, dignity and equality
Communication/Knowledge:
- Provides accurate and timely written and verbal communication of information in a manner that is understood by all.
- Able to listen, understand, problem-solve, and carry-out duties to ensure the optimal outcome.
- Able to use IT systems in an accurate and proficient manner.
Collaboration/Teamwork:
- Contributes toward effective, positive working relationships with internal and external colleagues.
- Demonstrates cooperation, flexibility, reliability, and dependability in all daily work activities and a willingness to collaborate with others for the good of the customer and the organization
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Equiliem
Jun 26, 2025