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Biller/Collector III Location: Duarte, CA/ Remote Duration: 9 Months Description: Collects and recovers the payment from patients and insurance companies for delinquent hospital/medical patient accounts. Initiates outbound calls that potentially lead to successful payment or timely arrangement to satisfy delinquent accounts. Talks with payers, such as commercial insurance, Medicare, and Medicaid, to resolve problems and gather additional information needed to collect debt. Works with customers to find and arrange collection solutions. Ensures billing is complete and accurate.5-10 years of experience Position Summary: Under the direction of the PFS Manager, the PFS Supervisor is responsible for immediate supervision of Collection, Billing, and other PFS representatives as assigned. Responsible for timely billing and follow-up of accounts processed through specific third party payers. Responsible for monitoring specific patient accounts referred to outside collection agencies and attorney. Essential Functions: Promotes quality management by initiating/participating in specific reviews and assists with quality monitoring. Reviews top 100 A/R accounts by balance to validate accounts are being worked in a timely and effective manner in accordance with department policies and procedures. Reviews denial reporting for electronic and paper remittances. Evaluates escalated issues from PFS representatives, resolving and further escalating as appropriate. Participates in departmental and organization-wide meetings/workgroups. Assists with special projects as assigned. Monitors employee performance and productivity. Provides supervisory support. Identifies priority accounts for immediate follow-up from the claim scrubber. Identifies priority accounts for immediate follow-up from the Eclipsys DNFB reports. Resolves priority accounts. Contacts patients/guarantors and/or third-party payers via internet, telephone, correspondence and meetings to resolve outstanding balances in accordance with departmental follow-up procedures. Responds to correspondence and calls forwarded from the customer service unit. Investigates and/or ensures that questions and requests for information are responded to in a timely and professional manner to ensure resolution of outstanding accounts. Works with other outside services to develop and monitor reimbursement. Analyzes accounts and determines when accounts are uncollectable. Prepares write-off recommendations in accordance with established departmental policies and procedures. Maintains within the system of record documentation of account activity and actions taken to effect collection. Documents accurate data (such as cash, adjustments, write-offs, etc.) for management reports. Updates account receivable within the system of record with appropriate transactions to reflect current billing and/or collection status. Performs general audit of claims for accuracy. Edits, prepares and forwards claims appropriately for hard copy or electronic billing via CIRIUS or automated systems. Reviews necessary billing information and documents required by various third parties/patients prior to the processing of claim. Prepares credit and/or debit documents per department policy. Maintains established productivity levels for the unit. Prepares daily activity reports. Maintains professional growth and development and keeps abreast of latest trends in area of expertise. Maintains current knowledge of collection policies and procedures and related legislation. Maintains a positive customer service image when dealing with department personnel, patients, physicians, insurance companies and other City of Hope employees. Follows established City of Hope and department policies, procedures, objectives, performance improvement, attendance, safety, environmental, and infection control guidelines, including adherence to the workplace Code of Conduct and Compliance Plan. Practices a high level of integrity and honesty in maintaining confidentiality. Performs other related duties as assigned or requested. Minimum Education: Bachelor's Degree. Experience may substitute for minimum education requirements Minimum Experience: 3-5 years of Medical Business Office experience in a physician’s office or hospital 1-3 years supervisory experience Excellent human relation skills Healthcare revenue cycle experience required. Preferred Field of Expertise: Patient Financial Services – Billing and Collections Skills/Abilities: Knowledge of Fair Debt Collection Practices Act. Knowledge of eligibility requirements for Charity/Indigent Care Plan and other third party carriers such as Medicare, Medicaid, Managed Care, and Commercial Payers. Strong analytical skills, including math and computer skills.

As an equal opportunity employer, ICONMA provides an employment environment that supports and encourages the abilities of all persons without regard to race, color, religion, gender, sexual orientation, gender identity or express, ethnicity, national origin, age, disability status, political affiliation, genetics, marital status, protected veteran status, or any other characteristic protected by federal, state, or local laws.