JOB SUMMARY

Review cases for denials that may have been billed or denied incorrectly for accuracy of charges.  The Collector II, under general supervision and according to established procedures, performs collection activities for assigned accounts. Reviews denied claims and audits received from insurance companies to determine accuracy. Gathers all pertinent information to support the denial, posts adjustments, contacts insurance companies by telephone or through provider portals to determine accuracy of denial. Maintains collection files on the accounts receivable system.

ESSENTIAL FUNCTIONS OF THE ROLE

• Performs collection activities for assigned accounts. Contacts insurance companies to verify authorizations, level of care, denial reason(s), and/or to send claim back for reprocessing.
• Calls insurance companies to verify the authorization was for the correct facility, date range, and services to verify if the case is approved.
• Maintains collection files on the accounts receivable system(s). Enters detailed records consisting of any pertinent information needed for denial/audit review.
• Processes account for write-off. Conducts thorough research and manual calculation to determine accurate amounts due to BSWH per each individual Insurance Contract.
• Enters data into Patient Accounting systems to refer accounts to the Appeal Writer team for review of appeal decision.
• Through review, ensures that balances on accounts are true and accurate, as well as correct any contractual or payment entries. Verifies insurance coding to ensure accurate payments.

• Performs other position appropriate duties as required in a competent, professional and courteous manner.

KNOWLEDGE, SKILLS, ABILITIES

• Insurance Collections experience of at least 2 years.
• Knowledge in Federal and State mandates and how to research for additional information when needed.
• Knowledge in Government insurance companies, Commercial insurance companies, Workers Compensation insurance companies and their billing guidelines and practices and payer portals.
• Knowledge in the difference between UB claim form and 1500 claim form, how charges are billed to various payers, and the different bill types for billing insurance claim forms.
•  Knowledge of how to do insurance follow-up on cases DRC is working.

BENEFITS

Our competitive benefits package includes the following

• Immediate eligibility for health and welfare benefits
• 401(k) savings plan with dollar-for-dollar match up to 5%
• Tuition Reimbursement
• PTO accrual beginning Day 1

Note: Benefits may vary based upon position type and/or level

QUALIFICATIONS

• EDUCATION - H.S. Diploma/GED Equivalent
• EXPERIENCE - 2 Years of Experience

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About Baylor Scott & White Health

Baylor Scott & White Health (BSWH) is the largest not-for-profit health care system in Texas and one of the largest in the United States. With a commitment to and a track record of innovation, collaboration, integrity and compassion for the patient, BSWH stands to be one of the nation’s exemplary health care organizations. Our mission is to serve all people by providing personalized health and wellness through exemplary care, education and research as a Christian ministry of healing. Joining our team is not just accepting a job, it’s accepting a calling!

Connections working at Baylor Scott & White Health

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