Claims Recovery Collector I

  • ID: 524584
  • Posted: 3/15/2023
  • Location: Irving, TX
  • Category: Admin - Administrative
  • Job Type: Temporary
  • Duration: 3 - 6 Months


Acara Solutions is looking for a Claims Recovery Collector for our client located in Irving, TX

  • Responsible for recovering payments from commercial insurance carriers who should have paid primary to the Medicaid agency.
  • Confer with Physicians/Providers by telephone, fax, and email inquiries regarding outstanding overpayment recovery
  • Communicate with claims adjudicators for commercial carriers by telephone, fax, and email to determine claim status and create claim-level appeals.
  • Leverage RCM Knowledge to assess denials, pursue appeals or close claims when appropriate.
  • Utilize and update client systems with proper notation of provider/carrier commentary, actions, and appeal/denial information.
  • Responsible for initiating inquiries to other parties as needed to address claim adjudication issues or resolving inquiries associated with claims adjudication.
  • Mail/fax/email letters to Physicians/Providers regarding payment of outstanding claims.
  • Contact providers to obtain additional information or documentation to resolve unpaid claims.
  • Pursue each outstanding account to reach maximum reimbursement by working with subject matter experts to resolve challenging claims.
  • Develop recovery strategies with each claim adjudicator, or physicians/providers associated with the claim billing.
  • Assists with high priority special projects.
  • Confer with carriers by telephone or use carrier portals, or other web sites to determine member eligibility and claim status.
  • Assess denials, pursue appeals, or close claims when appropriate.
  • Update case management system with proper noting of actions and appeal/denial information.
  • Respond to carrier telephone, fax, and e-mail inquiries regarding outstanding claims.
  • Work with document imaging system for archival purposes.
  • Ensure that payers adhere to laws regarding timely filing of claims.
  • Training responsibilities limited to projects and specific tasks.

Pay and Benefits:

  • The Salary for this position is $17.70 per hour (Max Pay rate).
Job Requirements

Required Skills / Qualifications:
  • High School Diploma or GED.
  • Minimum of 2 years' experience in billing/coding which included significant use and application of CPT/ICD codes and standard health industry claim billing forms.
Preferred Skills / Qualifications:
  • Associate degree in healthcare or medical billing or coding.
  • Experience handling and interpreting medical records, EOBs, and standard health industry claim billing forms
  • Good understanding of third-party billing and/or claims processing.
  • Ability to use critical thinking skills.
  • Possess good customer service skills.
  • Ability to adapt to change.
  • Ability to manage time effectively and multi-task.
  • Ability to prioritize work.
  • Ability to perform basic calculations.
  • Ability to work proficiently with Microsoft Windows, Word and have basic knowledge of Excel.
  • Average manual dexterity in use of a PC, phone, sorting, filing and other office machines.
  • Ability to be detail oriented.
  • Ability to learn and follow HIPAA privacy and Security rules.
  • Ability to work independently to meet predefined production and quality standards.
  • Ability to perform well in a team environment to achieve business goals.
  • Familiarity with basic computer usage and applications.
  • Ability to communicate and exchange information.
  • Ability to comprehend and interpret documents and data.
  • Needs manual dexterity to use computer, telephone, and peripherals.
  • Able to demonstrate knowledge of medical terminology, coding, billing and claims processing.

Additional Information:

  • Upon offer of employment, the individual will be subject to a background check and a drug screen.
  • Primarily sedentary work in a general office environment.
  • Needs occasional standing, walking, lifting, and moving objects (up to 10 lbs.).
  • Needs to work extended hours for special business needs.

Aleron companies (Acara Solutions, Aleron Shared Resources, Broadleaf Results, Lume Strategies, TalentRise, Viaduct, and Aleron's strategic partner, SDI) are Equal Employment Opportunity and Affirmative Action Employers. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender identity, sexual orientation, national origin, genetic information, sex, age, disability, veteran status, or any other legally protected basis. The Aleron companies welcome and encourage applications from diverse candidates, including people with disabilities. Accommodations are available upon request for applicants taking part in all aspects of the selection process.

Applicants for this position must be legally authorized to work in the United States. This position does not meet the employment requirements for individuals with F-1 OPT STEM work authorization status.

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