The posting
POSITION SUMMARY: The Collections Coordinator is responsible for performing all collections functions after claims have been submitted and processed. This role involves proactive follow-up with payers, meticulous denial management, and accurate account reconciliation to maintain a healthy accounts receivable (AR).
ESSENTIAL RESPONSIBILITIES AND DUTIES INCLUDE BUT ARE NOT LIMITED TO THE FOLLOWING:
- Executes targeted follow-up on outstanding accounts with Medicare, Medicaid, and commercial carriers based on AR aging reports to facilitate timely payment.
- Thoroughly researches the cause of payment denials (e.g., lack of authorization, documentation errors, untimely filing) and executes the necessary steps for resolution, correction, and resubmission or appeal.
- Prepares and submits formal appeals for denied claims, gathering required documentation (clinical and administrative) to overturn the payer's initial decision.
- Accurately reconciles posted payments with expected reimbursement, identifying discrepancies and contractual short-pays that require further follow-up.
- Manages the patient portion of collections, including generating and mailing statements, and communicating with patients regarding payment plans in a professional and compliant manner.
- Documents all collection activities, communications with payers, and status updates on the patient's account within the EMR system clearly and accurately.
- Reports common denial codes and collection roadblocks to the Billing Lead or Director of RCM to help identify and resolve upstream process issues.
- Other appropriate services and special projects as assigned.
The above statements are only meant to be a representative summary of the major duties and responsibilities performed by incumbents of this job. The incumbents may be requested to perform job-related tasks other than those stated in this description.
QUALIFICATIONS & REQUIREMENTS FOR THE POSITION:
- Minimum of 1 year of experience in medical collections, accounts receivable follow-up, or denial appeals, with experience in Home Health or Hospice preferred.
- Solid working knowledge of reading and interpreting EOBs (Explanation of Benefits), RAs (Remittance Advices), and payer correspondence.
- Proven ability to submit claims and track payment status through payer portals and a dedicated EMR system.
- Familiarity with the Medicare appeals process (e.g., Redetermination).
The employer for this position is stated in the job posting. The Pennant Group, Inc. is a holding company of independent operating subsidiaries that provide healthcare services through home health and hospice agencies and senior living communities located throughout the US. Each of these businesses is operated by a separate, independent operating subsidiary that has its own management, employees and assets. More information about The Pennant Group, Inc. is available at http://www.pennantgroup.com.
