Collection Specialist

General Summary/Purpose:
Responsible for the collections of unpaid medical insurance claims, and follow up on unpaid medical claims, as well as appealing these claims.

Note: This position does not provide visa sponsorship.

Specific Duties and Responsibilities:

• Uses system collection reports, such as: aged trial balances, data search reports, and the Paperless Collection System (PCS) to identify unpaid claims for collection/appeals.
• Communicates with third-party payers, patients, physicians, and other parties to resolve unpaid claims.
• Reviews and updates patient registration information (demographic and insurance) on IDX as needed.
• Utilizes PCS to process A/R. Works PCS files to completion.
• Applies appropriate discounts/courtesies based on department policy.
• Prints and mails claim forms and statements according to the follow-up matrix. Retrieves supporting documents (medical reports, authorizations, etc.) as needed and submits to third-party payers.
• Identifies and informs the Supervisor/Production Unit Manager of issues or problems associated with non-payment of claims.
• Appeals rejected claims and claims with low reimbursement.
• Identifies and informs management of systems or operational issues affecting collections, reimbursement and/or day in accounts receivable.
• Processes third-party payer correspondence for resolution and/or payment of claims.
• Researches and resolve Production Unit posting errors during the month.
• Performs miscellaneous related duties and special projects as assigned.

Minimum qualifications (mandatory):

• High school diploma/GED.
• 1 year of medical billing experience.
• Knowledge of medical terminology, CPT codes and ICD-9 codes.

Preferred qualifications:

• 2 years related experience.
• Experience in IDX and PCS.
• Database experience .

Special Knowledge, Skills, and Abilities:

• Ability to use various billing and patient information computer systems.
• Knowledge of various payer processing and submission guidelines.
• Knowledge of third party payer requirements.
• Proficiency with IBM personal computers to include Word, spread sheeting in either Lotus or Excel and possible.
• Capable of meeting deadlines and focusing on details.
• Excellent customer service and communication skills, ability to diffuse difficult situations in a complex environment.
• Good understanding of third party reimbursement policies and protocols.

Specific Physical Requirements:

• Sitting, standing and walking for extended period. Reaching by extending hand(s) or arm(s) in any direction.

Classified Title:Collection Specialist
Role/Level/Range: ATO 40/E/02/OC
Starting Salary Range:$13.36-18.41 /Commensurate with experience
Employee group: Full Time
Schedule: M-F 8am-4:30pm
Exempt Status: Non-Exempt
Location: 04-MD:School of Medicine Campus
Department name: 10003116-SOM PMR Production Unit Billing
Personnel area: School of Medicine

The successful candidate(s) for this position will be subject to a pre-employment background check.

If you are interested in applying for employment with The Johns Hopkins University and require special assistance or accommodation during any part of the pre-employment process, please contact the HR Business Services Office atjhurecruitment@jhu.edu. For TTY users, call via Maryland Relay or dial 711.

The following additional provisions may apply depending on which campus you will work. Your recruiter will advise accordingly.

During the Influenza ("the flu") season, as a condition of employment, The Johns Hopkins Institutions require all employees who provide ongoing services to patients or work in patient care or clinical care areas to have an annual influenza vaccination or possess an approved medical or religious exception. Failure to meet this requirement may result in termination of employment.

The pre-employment physical for positions in clinical areas, laboratories, working with research subjects, or involving community contact requires documentation of immune status against Rubella (German measles), Rubeola (Measles), Mumps, Varicella (chickenpox), Hepatitis B and documentation of having received the Tdap (Tetanus, diphtheria, pertussis) vaccination. This may include documentation of having two (2) MMR vaccines; two (2) Varicella vaccines; or antibody status to these diseases from laboratory testing. Blood tests for immunities to these diseases are ordinarily included in the pre-employment physical exam except for those employees who provide results of blood tests or immunization documentation from their own health care providers. Any vaccinations required for these diseases will be given at no cost in our Occupational Health office.

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