Credit & Collection Rep I (CNPA)

Kids Are Our Everything.

 

Department

10121 Patient Cash Application

 

Pay Range

$19.65 - $32.75

 

 

The Credit & Collections Representative 1 (CP&A) will be responsible to follow-up and find a resolution of guarantor/insured liability in accordance with CP&A Policy and Procedure. Establish and follow-up on guarantor payment agreements. Responsible for incoming calls and telephone coverage to assist caller with questions and complaints using the highest customer service skills. Investigate account and insurance reimbursement questions to the guarantor/caller satisfaction. Ability to resubmit or appeal claims on behalf of the insured as necessary .

 

Minimum Education
High School Diploma or GED (Required)

Minimum Work Experience
4 years Physician Business Office (Required)

Required Skills/Knowledge
Computer skills using Windows, Payer Web Search, Excel, Word.
Knowledge of insurance billing and reimbursement/patient liability.
Guarantor collections and AR process.
Understanding of managed care contracts and insurance compliance.
Excellent communication (written and oral) and customer service skills.

Functional Accountabilities
Customer Service/Phones

• Responsible for coverage of incoming calls between 8:00am and 4:30pm.

• Respond to patient and Practice inquires.

• Resolve patient questions with Practice/Provider, Insurance and Revenue Cycle Manager as necessary .

Patient Account Review

• Review account activity to ensure that all insurance including secondary for DOS has been sequenced, filed and credited appropriately.

• Review statement activity and billing cycle to ensure that the patient is receiving statements with a minimum of two statements prior to collection activity .

• Document and note all findings and actions taken on account and/or Finance Notes according to CP&A policy

Insurance Follow Up

• Research questions identified through account evaluation or patient inquiry contacting the payer if necessary.

• Take necessary action to correct, resubmit or appeal claims denied inappropriately .

• Consult with insurance follow-up to ensure rebill/appeal actions are appropriate and communicate identified charge errors or payer changes to insurance follow-up.

• Verify and apply secondary insurance and file claim if applicable.

Guarantor Collections and Payment Arrangement

• Contact guarantor to collect balance in full for assigned age group/Practice following CBO collection guidelines.

• Establish payment arrangement based on CBO procedure.

• Establish a follow-up process to ensure that payment plan agreements are honored.

• Manage AR age for assigned age/Practice to ensure that guarantor balances are resolved within the expected time frame following CP&A policy.

• Take necessary steps to recommend transfer to collections if guarantor is not compliant within the promised time frame.

Adjustments/ Collections

• Process authorized adjustments following CBO procedure.

• Review unapplied cash and work with Team Leader to transfer if applicable.

• Transfer authorized accounts to collections following CBO procedure.

• Document and note all findings and actions taken on account and/or Finance Notes according to CP&A policy.

 

The disclosed salary range includes the minimum and maximum rates within which Children’s National believes an individual’s base pay rate will fall for this position. It is not typical for an individual to be hired at or near the maximum of the pay range. The exact pay rate for this position will be based on a variety of factors in alignment with the Children’s National compensation philosophy. These factors are legitimate and non-discriminatory including, but not limited to, the current market conditions; organizational needs; the individual’s combination of prior work experience, level of education, knowledge, skills, and other qualifications. Children’s National is committed to providing a fair and competitive total rewards package to each of our employees. This base salary range does not include our comprehensive benefits package or any additional compensation for which this position may be eligible.

 

Childrens National Hospital is an equal opportunity employer that evaluates qualified applicants without regard to race, color, national origin, religion, sex, age, marital status, disability, veteran status, sexual orientation, gender, identity, or other characteristics protected by law. The “Know Your Rights” poster is available here: and the pay transparency policy is available here: Know Your RightsPay Transparency Nondiscrimination Poster.

 

Please note that it is the policy of Children's National Hospital to ensure a “drug-free” work environment: a workplace free from the illegal use, possession or distribution of controlled substances (as defined in the Controlled Substances Act), or the misuse of legal substances, by all staff (management, employees and contractors). Though recreational and medical marijuana are now legal in the District of Columbia, Children's National and its affiliates maintain the right, in accordance with our policy, to enforce a drug-free workplace, including prohibiting recreational or prescribed marijuana.