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Collections Representative

Location:Portland, ME
Employment Type:Full Time
Department:Administrative
Description:

Spurwink’s Finance department seeks an experienced Collections Representative to follow up on denials and outstanding accounts receivable for the agency, including outstanding Maine Care accounts greater than 30 days old, Medicare, third party insurance and miscellaneous billing accounts older than 60 days. You’ll also follow up, correct and resubmit claims for all government and non-government denials in a timely manner, and coordinate the monthly self-pay billing and respond to any patient inquiries regarding the bills.

Duties:

The Collections Representative will report to the Assistant Patient Accounts Manager and will be responsible for the following duties:

* 1. Follow up on all outstanding Maine Care accounts greater than 30 days old.
• Submit bills electronically using internal software compatible with the State of Maine.
• Achieve a 2 – 3 week turnaround time for payment receipt.
• Reconcile all submissions to Maine Care.

* 2. Follow up on all outstanding Medicare, Third Party Insurance, and Miscellaneous Billing accounts greater than 60 days.
• Submit claims on payer-preferred format until such time that electronic submission is
established. Once established, submit claims electronically.
• Reconcile all billing prior to submission to Medicare or Third Party Insurance Carriers.

* 3. Follow up, correct and resubmit claims for all incoming Government and non-Government denials within 5 business days of receipt of Explanation of Benefits.

* 4. Identify billing inconsistencies and communicate these inconsistencies back to the staff.

* 5. Coordinate the monthly Self-Pay Billing and respond to any patient inquiries regarding the bills.
• Prepare and send statements
• Establish payment arrangements on outstanding balances
• Identify accounts that need to be sent to the collection agency

6. Develop a tool to trend denial reasons by:
• Most common denial reason
• Which programs are receiving the most denials
• Total dollars held up by denials

7. Perform as a backup for cash posting.

8. Perform as a backup for insurance verifications.

9. Develop, update and implement Collections Policies and Procedures.

10. Perform various other duties as deemed appropriate and necessary by the Assistant Patient Accounts Manager, the Patient Accounts Manager, the CFO or the Treasurer.

Qualifications:

Education and Experience: High school diploma or equivalent required. Three or more years of experience preferred.

Knowledge, Skills and Abilities Necessary: A minimum of two years of experience in Third Party billing/reimbursement and one year of collections. Ability to prioritize multiple tasks effectively. Excellent interpersonal and communication skills are a must. Willingness to work effectively in a team oriented environment. Familiarity with personal computer spreadsheets and database packages including Excel, Microsoft Word, and Accounts Receivable financial software.

Spurwink is an Equal Opportunity Employer.

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