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CO Collection Specialist

Employer
Johns Hopkins University
Location
Maryland, United States
Salary
Salary Not Specified
Posted Date
Apr 1, 2022

View more

Position Type
Administrative, Business & Administrative Affairs, Other Business & Administrative Affairs, Financial Affairs
Employment Type
Full Time
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The CO Collection Specialist is responsible for the basic collection of unpaid third-party claims and standard appeals, using various JHM applications and JHU/ PBS billing applications. The Specialist will understand claims submission requirements for payors to expedite payments and possess a knowledge of appeals and rejections processes to resolve standard issues or escalate to a more senior specialist. Communicates with payers to resolve issues and facilitate prompt payment of claims. Follow-up with insurance companies to collect outstanding accounts for which payment has not been received in response to the claims submission process, either electronically or by paper. Recognize and resolve incorrect demographic and insurance registration based on understanding the outpatient registration process.

Specific Duties & Responsibilities:

Procedural Knowledge:

  • Uses A/R follow-up systems and reports to identify unpaid claims for collection/appeal.
  • Gathers and verifies all information required to produce a clean claim including special billing procedures that may be defined by a payer or contract.
  • Review and update patient registration information (demographic and insurance) as needed.
  • Applies appropriate discounts / courtesies based on department policy.
  • Prepares delinquent accounts for transfer to self-pay collection unit according to the follow-up matrix.
  • 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.
  • Appeals reflected claims and claims with low reimbursement.
  • Performs claim edits as needed.
  • Confirm credit balances and gathers necessary documentation for processing refund.
  • Identifies insurance issues of primary vs. secondary insurance, coordination of benefits eligibility and any other issue causing non-payment of claims.
  • Contacts the payors or patient as appropriate for corrective action to resolve the issue and receive payment of claims.
  • Monitor invoice activity until problem is resolved.
  • Process daily mail, edits reports, file or pull EOB batches.
  • Identifies and escalates non-standard appeals to a higher level specialist.
  • Informs the supervisor / Production Unit Manager of issues or problems associated with non-payment of claims.

Technical Knowledge:

  • Familiarity with compliance of HIPAA rules and regulations in the dissemination of patient Protected Health Information (PHI).
  • Working knowledge of medical billing applications.
  • Utilize online resources to facilitate efficient claims processing.

Professional & Personal Development:

  • Participate in on-going educational activities.
  • Keep current of industry changes by reading assigned material on work related topics.
  • Complete three days of training annually.

Service Excellence:

  • Must adhere to Service Excellence Standards.
  • Customer Relations
  • Self-Management
  • Teamwork
  • Communications
  • Ownership/Accountability
  • Continuous Performance Improvement
Supervision of Others:

N/A

Minimum Qualifications (Mandatory):

  • High School Diploma or equivalent required.
  • One year of experience in a medical billing or similar medical specialty environment required.
  • Minimum one-year medical billing [insurance] experience required;
Preferred Qualifications:

  • Knowledge of medical terminology, CPT codes and diagnosis coding required.
  • Excellent interpersonal, communication, and customer service skills are required.
  • Ability to use various billing and patient information computer systems preferred.
  • Knowledge of various payer processing and submission guidelines is preferred.

Special Knowledge, Skills, and Abilities:

Able to operate basic office equipment, e.g. photocopier, fax machine, scanner, PC, telephone, etc.

Classified Title: Collection Specialist
Working Title: CO Collection Specialist
Role/Level/Range: ATO 40/E/02/OC
Starting Hourly Pay Rate Range: $15.11 - $20.79/hr
Employee group: Full Time
Schedule: M-F/ 8:30a-5:00p
Exempt Status: Non-Exempt
Location: 42-MD:JH at Middle River
Department name: 10002800-SOM DOM 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 at jhurecruitment@jhu.edu. For TTY users, call via Maryland Relay or dial 711.

Johns Hopkins has mandated COVID-19 and influenza vaccines, as applicable. Exceptions to the COVID and flu vaccine requirements may be provided to individuals for religious beliefs or medical reasons. Requests for an exception must be submitted to the JHU vaccination registry. For additional information, applicants for SOM positions should visit https://www.hopkinsmedicine.org/coronavirus/covid-19-vaccine/ and all other JHU applicants should visit https://covidinfo.jhu.edu/health-safety/covid-vaccination-information/.

The following additional provisions may apply, depending on campus. Your recruiter will advise accordingly.

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.

Equal Opportunity Employer
Note: Job Postings are updated daily and remain online until filled.

EEO is the Law
Learn more:
https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf


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 at jhurecruitment@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.

Equal Opportunity Employer
Note: Job Postings are updated daily and remain online until filled.

EEO is the Law
Learn more:
https://www1.eeoc.gov/employers/upload/eeoc_self_print_poster.pdf
Important legal information
http://hrnt.jhu.edu/legal.cfm
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