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Hudson Regional Health · 17 hours ago

Billing & Collection Specialist

Clifton, NJ, US

Full-time

Onsite

New Grad, Entry Level

$19/hr - $23/hr

Hudson Regional Health is seeking a Billing & Collection Specialist to manage accounts receivable and ensure timely payment for commercial insurance and managed care claims. The role involves following up on claims, correcting billing errors, and collaborating with departments to enhance patient care and service.

Health CareHospital

Responsibilities

Follow-up on all claims from billing through final resolution for commercial insurance and managed care claims

Perform necessary correction to errors received from daily electronic billing reports, paper claim submissions and third party confirmation reports

Expedite payment of outstanding accounts through regularly scheduled follow up activity

Review system generated reports to identify accounts requiring research based on guidelines established by department

Determine appropriate action to be taken for resolution of accounts, securing prompt and accurate payment

Documents result in appropriate system(s) and Log

Alert Supervisor and/or Manager of non-payment trends

Research partial payments and determine if appropriate contractual allowance was calculated at time of billing based on reimbursement rules

Initiate corrective action for resolution of account, including collaboration with clinical department

Document results in appropriate system(s) or Log

Alert Supervisor and/or Manager of trends with miscalculation of contractual allowances

Research rejected and/or denied services

Determine corrective action to be taken

Complete corrective action, utilizing departmental procedures, policies, and document results in appropriate system(s) and Log

Complete productivity reports and forward to Supervisor per established time frame

Support customer service and performance improvement goals of the department; collaborate with other staff, within and outside the Department, to develop means of enhancing patient care and service

Maintain standards of confidentiality

Must possess ability to interact with variety of individuals as a problem-solver and have very good verbal and written communication skills

Strong analytical and organizational skills essential

Demonstrates excellent customer service skills when responding to incoming or outgoing calls in a most courteous manner providing clear and appropriate information as needed

Exercises good judgment towards account resolution and documents all activity on account in a clear, accurate and consistent manner utilizing appropriate system

Resolves credit balances in accordance to departmental policy and procedure

Maintains, process and log in AR records all requests for MR

Is knowledgeable of and adheres to all hospital policies and procedures including but not limited to: Attendance Management: Reports to work on time; is flexible when staffing needs warrant change; requests time off in a timely manner; consistently utilizes time clocks to document in and out shifts

Rules of Conduct: Respects the rights and property of others; does not engage in Harassment or Violence in the Workplace

HIPPA: Maintains confidentiality of patients, staff and visitors at all times

Dress Code: Complies with dress code policy and wears ID at all times

Successfully completed previous year’s goals or performance improvement plan

Performs other duties as assigned

Always introduces self to customers, patients and visitors professionally and courteously

Directs patients and visitors that appear to be lost; contributes positively to morale and demonstrates service excellence by being respectful, empathetic, helpful and attentive; response promptly to inquiries

Always treats all customers, co-workers with respect and professionalism per HR Rules of Conduct policy

Is 100% compliant with 90 day and annual performance reviews of staff by due date

Participates in Performance Improvement (PI) projects as set forth by manager

Maintains current and valid credentials/license with relevant governing body and/or stays knowledgeable of all changes in federal, state, local and regulatory body laws, rules and regulations

Is compliant with HIPPA rules, regulations, and current patient safety standards

Qualification

Billing system proficiencyClaims resolutionAnalytical skillsCustomer service skillsCommunication skillsHIPAA complianceOrganizational skillsProblem-solving skills

Required

Follow-up on all claims from billing through final resolution for commercial insurance and managed care claims

Perform necessary correction to errors received from daily electronic billing reports, paper claim submissions and third party confirmation reports

Expedite payment of outstanding accounts through regularly scheduled follow up activity

Review system generated reports to identify accounts requiring research based on guidelines established by department

Determine appropriate action to be taken for resolution of accounts, securing prompt and accurate payment

Document results in appropriate system(s) and Log

Alert Supervisor and/or Manager of non-payment trends

Research partial payments and determine if appropriate contractual allowance was calculated at time of billing based on reimbursement rules

Initiate corrective action for resolution of account, including collaboration with clinical department

Document results in appropriate system(s) or Log

Alert Supervisor and/or Manager of trends with miscalculation of contractual allowances

Research rejected and/or denied services

Determine corrective action to be taken

Complete corrective action, utilizing departmental procedures, policies, and document results in appropriate system(s) and Log

Complete productivity reports and forward to Supervisor per established time frame

Support customer service and performance improvement goals of the department

Collaborate with other staff, within and outside the Department, to develop means of enhancing patient care and service

Maintain standards of confidentiality

Possess ability to interact with variety of individuals as a problem-solver

Have very good verbal and written communication skills

Demonstrate excellent customer service skills when responding to incoming or outgoing calls

Exercise good judgment towards account resolution and document all activity on account in a clear, accurate and consistent manner utilizing appropriate system

Resolve credit balances in accordance to departmental policy and procedure

Maintain, process and log in AR records all requests for MR

Knowledgeable of and adheres to all hospital policies and procedures

Successfully completed previous year's goals or performance improvement plan

Perform other duties as assigned

Introduce self to customers, patients and visitors professionally and courteously

Direct patients and visitors that appear to be lost

Contribute positively to morale and demonstrate service excellence

Treat all customers, co-workers with respect and professionalism per HR Rules of Conduct policy

Be 100% compliant with 90 day and annual performance reviews of staff by due date

Participate in Performance Improvement (PI) projects as set forth by manager

Maintain current and valid credentials/license with relevant governing body