Apply on Employer Site

Children's Hospital of Philadelphia · 19 hours ago

Collections Associate

Philadelphia, PA

Full-time

Onsite

Entry Level

$24.87/hr - $31.09/hr

1+ years exp

Children’s Hospital of Philadelphia (CHOP) is dedicated to advancing pediatric care and offers numerous opportunities for career growth. The role of Collections Associate involves resolving low complexity patient accounts, managing claims, and ensuring accurate documentation in the patient accounting system to support efficient revenue cycle management.

Child CareHealth CareHospitalMedicalNon Profit

Growth Opportunities

Responsibilities

Submits timely, accurate claims to insurance carriers according to insurance payor guidelines through established methods and procedures using current available technology

Resolve patient insurance balances by analyzing denials and using critical thinking skills and knowledge of payer requirements to determine the steps needed to obtain payment. Work in either No Pay No Response, Denial work queues, or both

Based on payer processes, utilize payer portals, paper/electronic remits and/or place calls to the payer to understand and resolve denials

Perform adjustments as needed

Identifying third party payor response trending and escalation to management team as deemed necessary

Reviewing data sets CPT-codes, IDC-10 codes, HCPCS codes, coordination of benefits, registration discrepancies, third party payer rules, and payer contracts

Prioritize assigned work based on department needs and direction from leadership team

Follow workflows to route accounts to other CHOP departments (Case Management, Medical Records, Credit Resolution, Billing, Abstraction, Clinical Teams, Coding etc.) to address denials

Advise supervisor of contractual issues as discovered

Place phone calls, sends email or written communication to families to resolve denials that require intervention from the guarantor

Document each account thoroughly, explaining action taken on the account and completing note template provided

Files appeals on behalf of the patient to resolve denials. Reviews and acts on correspondence for assigned accounts

Position requires adherence to production and quality metrics

Identifies trends in assigned work queues and reports to leadership

Works accounts holistically, building on the last intervention and not repeating tasks

Identifies patients with multiple denials and works from a guarantor level to resolve issues completely for a family

Completes projects as assigned for specific payers or specific types of accounts, ensuring deadlines are met

Excellent oral and written communication skills with strong analytical skills

Suggests ideas and solutions for performance and quality improvement and provides feedback to team leaders

Demonstrates quality and effectiveness in work habits in every interaction with, colleagues, and leadership

Interfaces well with all levels of staff and management

Maintains all PHI in accordance with HIPPA, JACHO, third party contractual agreements along with CHOP policy and procedures

Demonstrates behaviors that are consistent with CHOP’s organizational values of Integrity, Compassion, Accountability, Respect and Excellence (ICARE). Ensures work is performed, relationships are built, responsibility is assumed, and service delivered expresses the CHOP’s values through action

Ability to communicate effectively and collaborate with teams across Patient Financial Services and other departments around operational efficiencies. Provide recommendations for corrective action to management team to ensure efficiency of the revenue cycle

Reports safety hazards, accidents and incidents, and unsafe working conditions promptly

Consistently supports compliance by maintaining the privacy and confidentiality of information, protecting the assets of the organization, acting with ethics and integrity, reporting non-compliance, and adhering to applicable federal, state, and local laws and regulations

Ability to communicate effectively and collaborate with teams across Patient Financial Services and other departments

Other duties as assigned within the scope of the responsibilities

Qualification

Billing experienceHIPAA complianceMicrosoft ExcelAnalytical skillsCommunication skillsCustomer service skillsBasic computer skillsHigh aptitude for mathTeamworkOrganizational skillsProblem solvingTime managementDetail orientedInterpersonal skills

Required

High School Diploma / GED

Demonstrated customer service skills, customer focus abilities and the ability to understand Children's Hospital of Philadelphia customer needs

Ability to work cooperatively in a team environment

Demonstrated effective interpersonal, verbal, and written communication skills

Knowledge of Microsoft Office applications including Word, Excel

Demonstrated experience with multiple computer applications

HIPAA compliance standards

Effective communication, interpersonal skills, analytical skills, and problem solving skills

Excellent organizational and time management skills

Detail and results oriented

High aptitude for math

Excellent writing and oral communication skills

Ability to work independently and prioritize work

Basic Computer skills

Preferred

Bachelor's Degree

At least one (1) year experience in billing, payment posting, operations, or related role

High proficiency in Microsoft Excel

Knowledge of third-party reimbursement and physician/hospital billing

Experience in using commonly used electronic health records and healthcare revenue cycle financial management systems

Experience with Epic systems

Company

Children's Hospital of Philadelphia

Glassdoor4.0

Since its start in 1855 as the nation's first hospital devoted exclusively to caring for children, The Children's Hospital of Philadelphia has been the birthplace for many dramatic firsts in pediatric medicine.

Founded in 1855

Philadelphia, Pennsylvania, USA

10001+ employees