Payor Collections Specialist IV

Job Description

Job Description

Description:

Titan Health Management Solutions (Titan) has been in operation since 2002 as a firm specializing in zero balance auditing and recovery. Our unique business model and expertise has allowed us to rapidly expand into other markets and other lines of business. We welcome you to visit our website at

We are searching for individuals who are passionate about what they do and have a strong desire to succeed. If you have an entrepreneurial spirit, and desire to push yourself beyond the limit of what you ever thought possible, come join our team and enjoy the success. Become part of a leading and innovative company in Revenue Cycle Services and watch your efforts help change healthcare for the better!

Position Summary

The Medical Collections Specialist achieves timely collection (payment) of outstanding hospital claim balances related to claim underpayments or denials. Collections may be related to appeals or grievances filed with health insurance plans/payors, corrected claims, assigned account balances, or other payment barriers. The position is responsible for the timely and complete collection of outstanding hospital insurance balances. This is achieved by following appropriate guidelines for billing, coding, collection, payment posting and customer service. Collection is achieved through follow up and coordination with individual insurance plans and their provider appeals and grievances departments.

Position Details

• Maintain collection aging targets per client goals and Titan policy – strive for collection within 45 days of initial activity.
• Maintain collection action/activity/frequency targets per client requirements and Titan policy.
• Data entry and tracking of follow-up and payment information into Titan and Client claims system
• Notation of Titan and Client claims systems on progressive activity.
• Timely collection of outstanding appeals/grievances,
• Consistent/timely follow-up by phone with the appropriate health insurance plan on each short pay or denial.
• Collection includes appeal logic arguments based on written appeal logic as presented by the Auditor.
• Assist with submission of appeal letters to the insurance plan/payor.
• Identify and submit materials required by the insurance plan/payor for resolution of the appeal/grievance.
• Identify and resolve denials, including escalation appeals to higher level as appropriate.
• Identify payments, including assistance with Client-specific invoice processes where required.
• Perform progressive action on every contact with an account, ensure that every time an account is worked the collection moves forward.
• Meet or exceed production and quality standards as defined by Titan and hospital client.

Education · High School Diploma or equivalent.

Experience

• Hospital billing experience preferred
• Hospital coding experience, certification preferred
• Customer and Client services experience
• Excellent oral and written communication skills
• Accurate in data entry
• Working knowledge of computer skills and Microsoft Windows/Word/Excel
• Working knowledge of Commercial, Medicare and Medicaid billing and claims
• Professional in both appearance and attitude

Pay Range: starting at $18.00 hourly