Providence St. Joseph Health

Job Information

St. Joseph Health / Covenant Health Associate Collections Rep in Lubbock, Texas

Covenant Health is seeking a full time Associate Collections Representative with the Patient Financial Service Department at Covenant Health System.

Job Summary:

Under the direction of the PFS manager (defined below by region), the Associate Collections Representative is responsible for performing insurance liability collection and accounts receivable activities for commercial accounts (PPO, HMO, POS, Managed Medicare/Medicaid, Private etc.) to ensure the timely receipt of insurance liabilities for hospital services. This individual follows up on accounts regularly to verify timely receipt of claim, check claim status, submit required documentation, and track overall claim processing. In addition, this individual identifies functional issues and barriers and reports them to the PFS Manager.

Essential Functions:

  • Complete and independently manage account follow-up based on preset follow-up guidelines defined by payor type and account balance:

  • Verify claim is received by commercial payor timely in accordance with the timely filing limits of the contractual agreement and/or state or federal regulations.

  • Monitor accounts receivable daily through work-lists and check claim status through payor claims department or online to ensure proper claims processing.

  • Complete periodic payor phone calls to confirm claim status and drive claim resolution as dictated by department collections policies.

  • Document follow-up activity or pertinent notes (e.g., date of receipt, reference number) within the system of record to track and record overall claim process history.

  • Obtain and submit any necessary documentation to support claim processing if required by the contractual agreement, payor guidelines, or state or federal law.

  • Report any critical account issues or barriers in the collections process to the Co-Op PFS Manager.

  • Trend and document ongoing payor issues and notify PFS management.

  • Ensure that all activities related to hospital collection functions meet department requirements, maximize revenue collection, and achieve leading practice levels of performance.

  • Daily focus on attaining productivity standards, recommending new approaches for enhancing performance, and productivity when appropriate.

Minimum Position Qualifications:

Experience : Experience in medical management computer applications

Preferred Position Qualifications:

Education: H.S. Diploma or GED

Experience:

  • 1 year Health care business office experience or related field

  • 3 years Collections experience and medical terminology

Covenant Health is seeking a full time Associate Collections Representative with the PFS SWCP Department at Covenant Health System.

Job Summary:

Under the direction of the PFS manager (defined below by region), the Associate Collections Representative is responsible for performing insurance liability collection and accounts receivable activities for commercial accounts (PPO, HMO, POS, Managed Medicare/Medicaid, Private etc.) to ensure the timely receipt of insurance liabilities for hospital services. This individual follows up on accounts regularly to verify timely receipt of claim, check claim status, submit required documentation, and track overall claim processing. In addition, this individual identifies functional issues and barriers and reports them to the PFS Manager.

Essential Functions:

  • Complete and independently manage account follow-up based on preset follow-up guidelines defined by payor type and account balance:

  • Verify claim is received by commercial payor timely in accordance with the timely filing limits of the contractual agreement and/or state or federal regulations.

  • Monitor accounts receivable daily through work-lists and check claim status through payor claims department or online to ensure proper claims processing.

  • Complete periodic payor phone calls to confirm claim status and drive claim resolution as dictated by department collections policies.

  • Document follow-up activity or pertinent notes (e.g., date of receipt, reference number) within the system of record to track and record overall claim process history.

  • Obtain and submit any necessary documentation to support claim processing if required by the contractual agreement, payor guidelines, or state or federal law.

  • Report any critical account issues or barriers in the collections process to the Co-Op PFS Manager.

  • Trend and document ongoing payor issues and notify PFS management.

  • Ensure that all activities related to hospital collection functions meet department requirements, maximize revenue collection, and achieve leading practice levels of performance.

  • Daily focus on attaining productivity standards, recommending new approaches for enhancing performance, and productivity when appropriate.

    Minimum Position Qualifications:

    Experience : Experience in medical management computer applications

    Preferred Position Qualifications:

    Education: H.S. Diploma or GED

    Experience:

  • 1 year Health care business office experience or related field

  • 3 years Collections experience and medical terminology

Covenant Health System is a faith-based ministry, focused on caring for the whole person - body, mind, and spirit - working with others to improve health and quality of life in our communities.

Thank you for applying with CHS. Your application will carefully be reviewed for the position(s) you have applied for. Please continue to seek career opportunities with us by visiting our web site at www.covenanthealth.org. Your interest in Covenant Health System is appreciated.

Covenant Health System provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, Covenant Health System complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.

Company: Covenant Health

Category: Billing/ Insurance

DirectEmployers