We are seeking a Collections Specialist who will be responsible for the collection of unpaid third-party claims and resolution of non-standard appeals, using various JHM applications and JHU/ PBS billing applications. Will conduct on-line research to locate information to resolve issues across different sub-specialties and/or relating to high-cost procedures. Communicates with payers to resolve issues and facilitate prompt payment of claims. Follow-up with insurance companies to collect outstanding accounts for which payment has not been received in response to the claim's submission process, either electronically or by paper. The Specialist will use a comprehensive knowledge of claims submission requirements for all payors in order to expedite payments. The Specialist will research and interpret medical policies regarding denials based on medical necessity. Will use a working knowledge of local coverage determinations (LCD's) to research and apply appropriately. Will mentor and advise junior specialists as appropriate.
Specific Duties & Responsibilities
Classified Title: Collection Specialist
Role/Level/Range: ATO 37.5/02/OC
Starting Salary Range: $15.50 - $25.00 HRLY ($49,000 targeted; Commensurate with experience)
Employee group: Full Time
Schedule: M-F, 7a-330p or 8a-430p
Exempt Status:Non-Exempt
Location:Hybrid/School of Medicine Campus
Department name: SOM PMR Production Unit Billing
Personnel area: School of Medicine