Career Center

The Commercial Billing/Collections Representative is primarily responsible for all account follow-up and resolution necessary to receive the expected reimbursement from all payer sources, through routine review of outstanding accounts.

Includes, but is not limited to the following:

• Expedites and maximizes payment of insurance medical claims by contact insurance payers by telephone or website
• Resolves all denials and requests for information
• Review and document all correspondence received and actions.
• Knowledgeable of major managed care plans with a firm collection approach
• Interpret contract terms to determine expected reimbursement and identify underpayments
• Submit professional financial appeals to payor within the deadlines set forth by the payors
• Account analysis and timely follow-up of outstanding accounts
• Communicate areas of concern/improvement to Leadership
• Other duties as assigned.

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Minimum Qualifications:

• High School Degree required, One (1) to two (2) years of college is preferred.
• Minimum 2 years’ experience billing Medicare, Medicaid and Commercial insurance companies in acute care setting. 
• Knowledge of third-party payers, collections laws, F.T.C. rulings, and collection procedures.
• Knowledge of third-party payer billing requirements.
• Knowledge of claims submission process for all major carriers and intermediaries.
• Proficient in the use of personal computer.

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