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Robert Half is offering a career building opportunity for a Collections Representative in the Healthcare/NHS industry, located in Philadelphia, Pennsylvania. As a Collections Representative, you will work on ensuring the correct and timely reimbursement from third-party payors for services provided.
Job Responsibility:
Manage and resolve accounts in compliance with contracts and agreements, which includes the review, analysis, and identification of possible barriers to correct and timely claim submission and processing
Maintain communication with insurance companies and third parties via telephone, letter, fax, or email as necessary and document all actions taken to resolve accounts
Review and manage credit balances, submit requests for refunds in accordance with policies or initiate off-sets/retractions of incorrectly paid services when possible
Investigate and submit for approval write off allowances and/or adjustments that have reasonable justification in accordance with contracts and policies
Handle insurance explanations of benefits that require other activities or reconciliation
Ensure that all claim submissions, appeals, and requested information is provided within the required timeframe to avoid filing issues and processing delays
Assist with special projects, audits, and reconciliation as necessary
Comply with all internal procedures and policies while maintaining a high level of customer service
Utilize Microsoft Excel and other analytics tools for data handling and review
Transfer accounts when necessary and only after confirming updated registration or eligibility
Requirements:
Demonstrated proficiency in Customer Service
Proficient in Microsoft Excel
Thorough understanding of procedures and policies
Strong analytical skills
Knowledge of compliance requirements within the healthcare industry
Experience in Payment Processing
Familiarity with Materials Handling
Ability to Review and analyze accounts and financial data
Experience with Accounts Receivable (AR)
Proficient in Email Correspondence
Understanding of insurance policies and claim processes
Familiarity with the software 'About Time'
Auditing skills, particularly within the healthcare industry
Knowledge of Benefit Functions within the healthcare setting
Experience in performing financial reconciliations
Proficiency in Billing and Collection Processes
Understanding of Revenue Accounting in a healthcare context
Experience in Claim Administration
Familiarity with Filing systems within a healthcare setting
Knowledge of Consumer Electronics
Ability to make financial adjustments as necessary
Familiarity with HealthCare.gov and its functions
Experience with document and claim Submission in a healthcare context
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