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Senior AR Collections Agent
2 weeks ago
Department: Revenue Cycle Management
Reports To: AR Collections Supervisor/Manager
Summary:
The Senior AR Collections Agent is responsible for the timely and effective collection of outstanding accounts receivable (AR) for healthcare services. This role involves in-depth knowledge of medical billing, coding, payer regulations, and collection techniques. The Senior Agent handles complex cases, provides guidance to junior team members, and plays a key role in improving the overall collection process.
Key Responsibilities:
Collections Activities:
- Manage and resolve complex and high-dollar AR claims.
- Investigate and analyze aged AR to determine appropriate collection strategies.
- Contact insurance companies, patients, and other responsible parties to pursue payment.
- Document all collection activities accurately and thoroughly in the billing system.
- Review and interpret Explanation of Benefits (EOBs) to identify discrepancies and denials.
- Appeal denied claims and follow up on pending appeals.
- Negotiate payment plans with patients according to established guidelines.
- Identify and escalate problematic accounts to management for further action.
- Understanding of HIPAA regulations and ensure compliance in all activities.
- Stay current on changes in payer regulations, coding guidelines, and billing requirements.
Problem Solving and Analysis:
- Identify trends in denials and payment issues and propose solutions to prevent recurrence.
- Work with other departments (e.g., billing, coding, registration) to resolve billing errors and process issues.
- Research and resolve complex billing inquiries from patients and insurance companies.
Mentorship and Training:
- Serve as a mentor and resource for junior AR Collections Agents.
- Assist in training new team members on collection procedures and systems.
- Provide guidance on handling difficult or complex accounts.
Reporting and Process Improvement:
- Prepare regular reports on AR status, collection rates, and key performance indicators (KPIs).
- Identify opportunities to improve collection processes and increase efficiency.
- Participate in team meetings and contribute to process improvement initiatives.
System Proficiency:
- Utilize billing software and other relevant systems to manage accounts and track collection activities (e.g., EPIC, Cerner, etc.).
- Maintain accurate and up-to-date information in the billing system.
Qualifications, Experience & Skills:
- Undergraduate degree or equivalent required; Associate's or Bachelor's degree in a related field preferred.
- Minimum of 5-7 years of experience in Phycian Billing/Hospital billing RCM AR collections.
- Proven track record of successfully collecting outstanding AR.
- Experience working with various insurance payers (e.g., Medicare, Medicaid, Commercial).
- In-depth knowledge of revenue cycle management
- Strong understanding of payer regulations and reimbursement processes.
- Excellent communication and interpersonal skills.
- Strong analytical and problem-solving abilities.
- Proficiency in using billing software and Microsoft Office Suite.
- Ability to work independently and as part of a team.
- Excellent organizational and time-management skills.
- Ability to handle a high volume of accounts and meet deadlines.
Preferred Qualifications:
- Experience with EPIC preferred but not mandatory
- Both Hospital and Professional billing experience preferred
- Flexible to work from Office all 5 days in the week in US shift
Additional Details : -
- Voice - AR Callers (Physician billing/Hospital billing)
