Collections Associate - Full-time

p style="text-align:left"spanSHIFT:/span/pDay (United States of America)p style="text-align:inherit"/pp style="text-align:inherit"/ppbspanSeeking Breakthrough Makers/span/b br / br /spanChildren’s Hospital of Philadelphia (CHOP) offers countless ways to change lives. Our diverse community of more than 20,000 Breakthrough Makers will inspire you to pursue passions, develop expertise, and drive innovation./span br /At CHOP, your experience is valued; your voice is heard; and your contributions make a difference for patients and families. Join us as we build on our promise to advance pediatric care—and your career. br / br /CHOP does not discriminate on the basis of race, color, sex, national origin, religion, or any other legally protected categories in any employment, training, or vendor decisions or programs. CHOP recognizes the critical importance of a workforce rich in varied backgrounds and experiences and engages in ongoing efforts to achieve that through equally varied and non-discriminatory means. /ppbr /br /bA Brief Overview/bbr /Primarily responsible for timely resolution of low complexity patient accounts. Assigned duties include researching account balances and following up with collection calls to insurers and parents. Reviewing claims with no response. Reviewing denied claims or underpaid claims and resolving the denial and filing appeals, as necessary. Ensuring all information pertaining to collection activity is fully and accurately documented in the patient accounting system. Works to identify payment and denial trends for timely resolution. Works to identify internal and external causes of denials for timely resolution. Ability to work independently or as a member of a project team. This position could be assigned to hospital, professional or home care claims. Supports the CHOP mission with efficient and effective revenue cycle management.br /br /bWhat you will do/b/pulliSubmits timely, accurate claims to insurance carriers according to insurance payor guidelines through established methods and procedures using current available technology./liliResolve patient insurance balances by analyzing denials and using critical thinking skills and knowledge of payer requirements to determine the steps needed to obtain payment. Work in either No Pay No Response, Denial work queues, or both./liliBased on payer processes, utilize payer portals, paper/electronic remits and/or place calls to the payer to understand and resolve denials./liliPerform adjustments as needed./liliIdentifying third party payor response trending and escalation to management team as deemed necessary./liliReviewing data sets CPT-codes, IDC-10 codes, HCPCS codes, coordination of benefits, registration discrepancies, third party payer rules, and payer contracts./liliPrioritize assigned work based on department needs and direction from leadership team./liliFollow workflows to route accounts to other CHOP departments (Case Management, Medical Records, Credit Resolution, Billing, Abstraction, Clinical Teams, Coding etc.) to address denials./liliAdvise supervisor of contractual issues as discovered./liliPlace phone calls, sends email or written communication to families to resolve denials that require intervention from the guarantor./liliDocument each account thoroughly, explaining action taken on the account and completing note template provided./liliFiles appeals on behalf of the patient to resolve denials. Reviews and acts on correspondence for assigned accounts./liliPosition requires adherence to production and quality metrics./liliIdentifies trends in assigned work queues and reports to leadership./liliWorks accounts holistically, building on the last intervention and not repeating tasks./liliIdentifies patients with multiple denials and works from a guarantor level to resolve issues completely for a family./liliCompletes projects as assigned for specific payers or specific types of accounts, ensuring deadlines are met./liliExcellent oral and written communication skills with strong analytical skills./liliSuggests ideas and solutions for performance and quality improvement and provides feedback to team leaders./liliDemonstrates quality and effectiveness in work habits in every interaction with, colleagues, and leadership./liliInterfaces well with all levels of staff and management./liliMaintains all PHI in accordance with HIPPA, JACHO, third party contractual agreements along with CHOP policy and procedures./liliDemonstrates behaviors that are consistent with CHOP’s organizational values of Integrity, Compassion, Accountability, Respect and Excellence (ICARE). Ensures work is performed, relationships are built, responsibility is assumed, and service delivered expresses the CHOP’s values through action./liliAbility to communicate effectively and collaborate with teams across Patient Financial Services and other departments around operational efficiencies. Provide recommendations for corrective action to management team to ensure efficiency of the revenue cycle./liliReports safety hazards, accidents and incidents, and unsafe working conditions promptly./liliConsistently supports compliance by maintaining the privacy and confidentiality of information, protecting the assets of the organization, acting with ethics and integrity, reporting non-compliance, and adhering to applicable federal, state, and local laws and regulations./liliAbility to communicate effectively and collaborate with teams across Patient Financial Services and other departments/liliOther duties as assigned within the scope of the responsibilities./li/ulp/ppbEducation Qualifications/b/pulliHigh School Diploma / GED - Required/liliBachelor#39;s Degree - Preferred/li/ulp/ppbExperience Qualifications/b/pulliAt least one (1) year experience in billing, payment posting, operations, or related role - Preferred/li/ulp/ppbSkills and Abilities/b/pulliDemonstrated customer service skills, customer focus abilities and the ability to understand Children’s Hospital of Philadelphia customer needs. (Required proficiency)/liliAbility to work cooperatively in a team environment. (Required proficiency)/liliDemonstrated effective interpersonal, verbal, and written communication skills. (Required proficiency)/liliKnowledge of Microsoft Office applications including Word, Excel. (Required proficiency)/liliDemonstrated experience with multiple computer applications. (Required proficiency)/liliHIPAA compliance standards (Required proficiency)/liliEffective communication, interpersonal skills, analytical skills, and problem solving skills. (Required proficiency)/liliExcellent organizational and time management skills. (Required proficiency)/liliDetail and results oriented. (Required proficiency)/liliHigh aptitude for math. (Required proficiency)/liliExcellent writing and oral communication skills. (Required proficiency)/liliAbility to work independently and prioritize work. (Required proficiency)/liliBasic Computer skills (Required proficiency)/liliHigh proficiency in Microsoft Excel. (Preferred proficiency)/liliKnowledge of third-party reimbursement and physician/hospital billing. (Preferred proficiency)/liliExperience in using commonly used electronic health records and healthcare revenue cycle financial management systems. (Preferred proficiency)/liliExperience with Epic systems (Preferred proficiency)/li/ulpbr / /ppbspanTo carry out its mission, CHOP is committed to supporting the health of our patients, families, workforce, and global community. As a condition of employment, CHOP employees who work in patient care buildings or who have patient facing responsibilities must receive an annual influenza vaccine. /span/ba href="https://careers.chop.edu/us/en/how-we-hire" target="_blank"bspanLearn more./span/b/a br / /ppa href="https://careers.chop.edu/us/en/eeo" target="_blank"bspanEEO / VEVRAA Federal Contractor/span/b/abspan | /span/ba href="https://careers.chop.edu/us/en/tobacco-statement" target="_blank"bspanTobacco Statement /span/b/a /pp style="text-align:inherit"/pp style="text-align:left"bSALARY RANGE:/b/pp style="text-align:inherit"/p$24.87 - $31.09 Hourlyp style="text-align:inherit"/pp style="text-align:left"Salary ranges are shown for full-time jobs. If you#39;re working part-time, your pay will be adjusted accordingly./pp style="text-align:inherit"/pp style="text-align:inherit"-------------------/pp style="text-align:inherit"/pp style="text-align:left"At CHOP, we are committed to fair and transparent pay practices. Factors such as skills and experience could result in an offer above the salary range noted in this job posting. Click a href="https://careers.chop.edu/us/en/benefits" target="_blank"spanuspanhere/span/u/span/a for more information regarding CHOP#39;s Compensation and Benefits./p