Community Health Systems SSC Insurance Collector in Antioch, Tennessee
Community Health Systems (CHS) Shared Services Center (SSC) Nashville, is hiring an Insurance Collector. This position is responsible for thorough collection and follow-up activity on insurance accounts in order to expedite claims processing and reimbursement. Must be able to analyze patient accounts to secure and provide information to help resolve any discrepancies regarding accounts with contact to the insurance companies, government agencies, patients and other responsible parties.
CHS is one of the leading operators of general acute care hospitals in the nation. The organizations affiliates own, operate or lease 126 hospitals in 20 states (mainly in the SE) with approximately 21,000 license beds and 90,000 employees. These affiliated hospitals are dedicated to providing quality healthcare for local residents and contribute to the economic development of their communities.
This position supports revenue cycle operations on behalf of the SSC assigned facilities (hospitals). The affiliated hospitals viability is based upon the SSC's ability to collect revenues for those services. In over 60 of the markets served, CHS affiliated hospitals are the sole provider of healthcare services.
Essential Duties and Responsibilities include the following: (Other duties may be assigned).
• Ensure accurate and complete account follow-up.
• Resolve claim processing issues in a timely manner, evaluating problem claims to the appropriate managerial personnel with the insurance carrier s organization to quickly resolve delinquent claims or contacting patient or third party payers in compliance with established policies and procedures.
• Review assigned claims working within the established productivity standards, for timely follow-up maintaining and updating all patient accounts to reflect current information.
• Assess each account for balance accuracy, payer plan and financial class accuracy, billing accuracy, denials, insurance requests, making any necessary adjustments, documenting appropriately and submits corrections or request for processing in a timely manner.
• Resolve claim processing issues on a timely basis by reviewing claim inventories, payments and adjustments and taking appropriate actions to ensure proper discounts and allowances have been completes as well as identifies account for secondary billing and processes of refers to appropriate personnel.
• Document all activity taken on an account in the patient account notes.
• Work any assigned correspondence related to assigned accounts.
• Perform other required duties in a timely, professional, and accurate manner.
Qualifications/knowledge/abilities: The functions listed below are representative of the knowledge, skill, and/or ability required to complete this job successfully:
• Must be able to communicate effectively and professionally with strong attention to details and problem solving both verbally and written.
• Strong telephone communications skills are required.
• Carrier-specific reimbursement as applicable to claim processing to include:
• Benefits and coverage according to specific carrier.
• UB 04 claims form preparation.
• 1500 claims form preparation.
• Ability to prioritize work and meet deadlines is required. Knowledge of general office procedures is required.
• Able to define problems, collect data, validate data, establish facts, and draw valid conclusions.
• Any collections experience in an Insurance Collector role or equivalent experience in a medical facility, ambulatory surgery facility, or acute-care hospital is a major plus.
• Knowledge of CPT, HCPCS, ICD-9 and medical terminology is highly desired.
To perform this job successfully, an individual should have intermediate level knowledge of Microsoft Office tools (Word, Excel, Outlook) as well as the hospital patient accounting systems (HMS, Artiva, and other related healthcare software).
• HS Diploma or GED equivalent required.
• 1 year of medical collection experience highly desired.
• Working in a hospital business office would be ideal.
The physical demands described are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Please note: This position requires that you work out of the newly constructed Cane Ridge Shared Services Center (SSC) in Antioch, TN.
Job: Business Office
Organization: Shared Services Center - Franklin
Requisition ID: 1824248
This organization does not discriminate in any way to deprive any person of employment opportunities or otherwise adversely affect the status of any employee because of race, color, religion, sex, sexual orientation, genetic information, gender identity, national origin, age, disability, citizenship, veteran status, or military or uniformed services, in accordance with all applicable governmental laws and regulations. In addition, the facility complies with all applicable federal, state and local laws governing nondiscrimination in employment.