Trilogy Behavioral Health

  • Medical Collector

    Req No.
    2018-2272
    Type
    Regular Full-Time
    Department
    Billing
  • Overview

    Trilogy Behavioral Healthcare Inc. strongly believes that treatment services are more effective when provided in the client’s natural setting, hence, the majority of services provided are located in the community.  Trilogy Behavioral Healthcare Inc. also employs a holistic approach to each client’s treatment and integrates all facets of our clients’ lives including mental/emotional health, physical health/wellness, employment and education, social and family relationships, substance use/abuse issues, and housing needs.

     

    Typical services provided include case management, counseling/therapy, individual skills training, medication training, crisis intervention, linkage to community resources, advocacy, assessment, and treatment planning.

    Responsibilities

    The Medical Collector is responsible for timely submission of claims to insurance companies from a wide variety of medical providers and facilities.  He/she/they will monitor, follow-up, and ensure that payments for medical services are received.  The Medical Collector may function as an intermediary between healthcare providers, clients, patients, and health insurance companies.

     

    Essential Responsibilities

    • Review client accounts for accuracy and completeness. Obtain missing information and submit claims to insurance companies and other payer sources for payment.
    • Identify insurance company or correct guarantor (client) to be billed; identify and bill primary, secondary, or tertiary insurances.
    • Utilize a combination of client electronic health record and paper records to assist with billing and claims. Maintain accurate and legally compliant health record. 
    • Review insurance payments for accuracy and compliance with contract discounts.
    • Review denials or partially paid claims and work with involved parties to resolve discrepancies.
    • Manage assigned accounts ensuring outstanding/pending claims are paid in a timely manner and contact appropriate parties to collect payment.
    • Communicate with health care providers, patients, insurance claim representatives and other parties to clarify billing issues and facilitate timely payment.
    • Consult supervisor, team members, and appropriate resources to solve billing and collection questions and issues.
    • Maintain work operations and quality by following standards, policies and procedures; escalate compliance issues to supervisor.
    • Prepare reports and forms as directed and in accordance with established policies.
    • Perform other related duties and/or projects as assigned

    Qualifications

    • High school diploma or equivalent. Associates Degree in Business Administration, Accounting, or Health Care Administration preferred
    • Medical billing, medical administration certificate, or diploma program preferred
    • Three years of training and/or experience in billing, collections, etc. highly preferred
    • Knowledge of insurance, especially Medicare/Medicaid rules and guidelines
    • Educated on and compliant with HIPAA regulations, understand medical terminology, and maintain strict confidentiality of patient and client information.
    • Strong organization skills, and ability to meet deadlines and productivity standards
    • Ability to work effectively within role independently and with other team members.
    • Excellent and professional customer service to internal and external customers.

     

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