Medical Collector - PB

LCMC Health; United States; On-site; USD 42,000 - 65,000; Full time

Job summary

LCMC Health in Louisiana is seeking an experienced healthcare billing/denials specialist to manage daily follow-ups, identify underpayments, and process appeals with third-party payers. You will review payments, analyze EOBs, and ensure accurate reimbursement while maintaining thorough documentation on patient accounts.

The role requires 2+ years in a healthcare billing environment, a high school diploma or GED, and strong communication and computer skills.

Qualifications

• Minimum two years of experience in a healthcare environment, particularly in healthcare billing, collections, payment processing, or denial management is preferred.
• Required: A high school diploma or GED.
• Must be able to pass basic computer skills test and system level training.

Responsibilities

• Maintains responsibility for accurate and timely completion of daily follow-up or denial account assignment.
• Identifies and analyzes underpayments to identify reasons for discrepancies and process denials and appeals as needed.
• Reviews posted payments and adjustments to ensure accuracy; analyzes EOBs for proper reimbursement.
• Completes appeals with third party payers, tracking, responding, and resolving as needed.
• Communicates with payers on outstanding claims to resolve payment variances and ensure timely reimbursement.
• Documents all activity on patient accounts accurately.

Skills

Healthcare billing

Denials management

Customer service

Time management

Analytical skills

Written communication

Computer literacy

Education

High school diploma or GED

Job description

Your Everyday

• Maintains responsibility for accurate and timely completion of daily follow-up or denial account assignment
• Identifies and analyzes underpayments to identify reasons for discrepancies and process denials and appeals as needed
• Reviews posted payments and adjustments to ensure accuracy. Analyzes EOBs to ensure proper reimbursement
• Conducts relevant research to complete appeals process to include assessing, complete and accurate documentation, tracking, responding to, and / or resolving appeals with third party payers in a timely manner
• Communicates with payers on outstanding claims, resolves payment variances and achieves timely reimbursement
• Accurately documents all activity on the patient account
• Collaborates with internal departments and external organizations to ensure correct reimbursement and resolve appeals
• Monitors underpaid and denied claims for trends and to identify root causes and reports findings to supervisor
• Demonstrates initiative and resourcefulness by making recommendations and communicating trends and issues to management
• Observes best practice processes in follow-up and customer service activities
• Participates in staff training that aligns with recognized improvement opportunities and increase understanding of Medicare/Medicaid requirements as well as general follow-up processes
• Acts in accordance with LCMC’s mission and values, while serving as a role model for ethical behavior
• Adheres to federal and state regulations related to the protection of patient information (e.g., the Health Insurance Portability and Accountability Act (HIPAA) as well as facility-specific guidelines

The Must-Haves

EXPERIENCE QUALIFICATIONS

• Minimum two years Of experience in a healthcare environment, particularly in healthcare billing, collections, payment processing, or denial management is preferred

EDUCATION QUALIFICATIONS

• Required: A high school diploma or GED

SKILLS AND ABILITIES

• Must be able to pass basic computer skills test and system level training
• Working knowledge of system reports and the ability to analyze system information to determine the impact of possible changes
• Demonstrates knowledge of:
  Hospital and professional billing processes and reimbursement
  Third-party contracting
  Insurance protocols, delay tactics, systems, and workflows
  ERISA guidelines for denials and appeals
  Regulations related to denials and appeals
• Ability to take initiative by identifying problems, conceptualizing resolutions, and implementing change
• Possesses efficient time-management skills and proven ability to multitask under tight deadlines
• Demonstrates excellent customer service skills
• Effective writing and communication skills
• Strong comfort level with computer systems

WORK SHIFT:

Days (United States of America)

LCMC Health is a community.

Our people make health happen. While our NOLA roots run deep, our branches are the vessels that carry our mission of bringing the best possible care to every person and parish in Louisiana and beyond and put a little more heart and soul into healthcare along the way. Celebrating authenticity, originality, equity, inclusion and a little “come on in” attitude is the foundation of LCMC Health’s culture of everyday extraordinary

Your extras

• Deliver healthcare with heart.
• Give people a reason to smile.
• Put a little love in your work.
• Be honest and real, but with compassion.
• Bring some lagniappe into everything you do.
• Forget one-size-fits-all, think one-of-a-kind care.
• See opportunities, not problems – it’s all about perspective.
• Cheerlead ideas, differences, and each other.
• Love what makes you, you - because we do

You are welcome here.

LCMC Health is an equal opportunity employer. All qualified applicants receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability status, protected veteran status, or any other characteristic protected by law.

The above job summary is intended to describe the general nature and level of the work being performed by people assigned to this work. This is not an exhaustive list of all duties and responsibilities. LCMC Health reserves the right to amend and change responsibilities to meet organizational needs as necessary.

Proof of citizenship or immigration status will be required to verify your lawful right to work in the United States.

We may use information on your application to verify your previous employment and background.

Applications are inactive after 6 months and, therefore, require a new application for employment to be completed.