HCA, Hospital Corporation of America Insurance Collections Specialist - EO in St Louis, Missouri

Headquartered in Nashville, Tenn., Parallon is a leading provider of healthcare business and operational services. Parallon partners with hospitals and healthcare systems to improve their business performance through best practices in a broad portfolio of revenue cycle services. Parallon is committed to bringing a deep and evolving knowledge, a long track record of operational excellence and a full suite of capabilities to all of its partnerships in order to help clients thrive in the communities they serve.

Collection Specialist-Insurance Follow-up

Description:

  • Working knowledge of all aspects of insurance claim filing, requirements and regulations.

  • Research account specifics to complete necessary follow-up actions related to medical collections

  • Place outbound calls to insurance companies, guarantors, patients, doctors’ offices and/or facilities and handle incoming calls as necessary in an attempt to resolve claims.

  • Analyze inventory to determine best next action to quickly resolve the accounts.

  • Ensure adjustments are posted timely and correctly for denied claims that need to be written off.

  • Post adjustment/write-offs if applicable.

  • Track and follow up on requests for refunds or recoupments in accordance with payer requirements.

  • Effectively Resolve Credit Balances according to regulatory and workflow requirements.

  • Follow-up on accounts by contacting third-party payers via telephone/mail or electronic means for payment status, according to schedule of disposition to be worked on given days.

  • Research, identify and rectify any special circumstances affecting resolution of customer account.

  • Update account in system with any action taken or additional information attained when verifying benefits.

  • Escalate issues to Team Lead or Unit Manager as necessary.

  • Strict adherence to HIPAA, HiTech and all state and federal regulations relating to account collections and patient privacy.

  • Practice and adhere to the "Code of Conduct" philosophy and "Mission and Value Statement" .

  • Adheres to and supports organizational IT&S standards, policies, and procedures.

  • Adheres to Code of Conduct.

  • Performs other duties as assigned.

KNOWLEDGE, SKILLS & ABILITIES

  • Medical and insurance terminology (such as procedure codes, diagnoses, and patient liability), and full understanding of hospital/physician billing.

  • Knowledge of collections helpful. Capable of meeting production goals. Policies & Procedures - demonstrates knowledge and understanding of organizational policies, procedures and systems.

  • Ability to remain flexible as this position may be working multiple clients at one time.

  • Basic skills - able to perform basic mathematical calculations, balance and reconcile figures, punctuate properly, spell correctly and transcribe accurately .

  • Customer orientation .

  • Interpersonal skills - able to work effectively with other employees, patients and external parties .

  • Communication and problem solving skills and the ability to act/decide accordingly.

  • Ability to resolve accounts, create and research complex or diverse information.

  • Exceptional customer service and the ability to plan organize and exercise sound judgment.

EDUCATION

  • High school diploma or equivalent .

 

EXPERIENCE

  • Minimum 1 year work experience in customer service, preferably in a medical setting. Prefer experience in Insurance, collections or related area.

  • Experience with Microsoft Office suite and standard office equipment (copier, fax machine) a must.

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Title: Insurance Collections Specialist - EO

Location: Missouri-St Louis-St Louis Shared Svcs (SLC SS) - RCPS

Requisition ID: 26587-136046