The Neuro Rehab Litigation Collection Specialist is a key associate at Hope Network whose primary responsibilities include: The collection of delinquent claims. Essential to this position is the ability to manage a high volume of inbound/outbound phone calls to insurance carriers, looking at contracts and drafting appeals, working with denials and underpayments from payers, and resolving payment descrepancies in an effort to avoid litigation.
ESSENTIAL FUNCTIONS AND RESPONSIBILITIES:
This is not intended to be an exhaustive listing of job functions. This job description in no way states or implies that these are the only duties to be performed by this employee. The employee is required to follow any other instructions and to perform any other duties as assigned.
1. Regular and predictable attendance is an essential requirement of this position.
2. Participate as an equal, active member of the Neuro Rehab Department.
3. Identify and interpret documentation in the billing system to determine charges billed and why payments were not received. This includes medical bills, EOB/EOR/Remittance documents, and SNB (Service Not Billed) reports.
4. Understand the coordination of commercial and auto insurance policies for collection purposes.
5. Make outbound calls to funders, bill review companies, and others to collect on unpaid claims.
6. Establish rapport with these contacts in an effort to improve payment processing on future claims.
7. Make follow up calls to be sure support documents were received and when payments can be expected.
8. Document all efforts of collections in eCare. Be sure copies of all appeals are kept in eCare.
9. Produce data tracking spreadsheets of the services, charges, payments, adjustments, and balances due for the collections of unpaid claims.
10. Identify issues and trends attributing to account delinquency and present solutions to Management.
11. Use coding guidelines and Corporate policy in collecting outstanding charges.
12. Maintain Metrics on assigned accounts to track successes.
13. Maintains a high level of technical knowledge and expertise regarding current and pending regulations, legislation and the potential impacts on the billing and collections process applicable to commercial funders and the Michigan No-Fault Act and its impact on Hope Network.
14. Adheres to the Neuro Rehab policies and procedures.
Educational / Talent Requirements:
1. Knowledge and experience working in the billing/collections of a medical provider OR minimum of three years experience as a Michigan No-Fault PIP adjuster.
2. Strong skills Adobe Pro XI and Excel software along with knowledge of fax, copy, scan office equipment.
3. Strong organizational and time management skills.
4. Well-developed mathematical, analytical and problem solving skills.
5. Excellent communication skills both written and verbal.
6. Sit for long periods in front of a computer with occasional time on the phone throughout the entire workday.
7. Demonstrated ability to work collaboratively with internal and external customers.
Work Experience Requirements:
1. At least three years experience in the billing/collection department of a medical provider dealing with auto insurance companies. OR
2. At least three years experience as a Michigan No-Fault PIP Adjuster.
3. Demonstrated knowledge of commercial and government billing.
4. Demonstrated proficiency in the use of technologies: Microsoft Office, specifically in the use of Excel; Electronic Medical Records; insurance eligibility such as CHAMPS and Web-Denis; etc.
5. Ability to travel on behalf of Hope Network when needed and requested; must maintain a valid Michigan driver license, and adhere to the driving policy outlined in Hope Network’s employee manual.