Underpayment Collection Specialist

at  Franciscan Health

WHO WE ARE

With 12 ministries and access points across Indiana and Illinois, Franciscan Health is one of the largest Catholic health care systems in the Midwest. Franciscan Health takes pride in hiring coworkers that provide compassionate, comprehensive care for our patients and the communities we serve

• Analyzes the contract matrix and reconciles to payments received.
• Reviews and validates action needed for reconsideration of all assigned underpaid accounts.
• Payor Collaboration
• Contacts payors to have adjustments processed if payments are not in accordance with current contract agreements.
• Successfully collects underpayments.
• Underpaid Claim Follow up
• Ensures follow up of underpaid claims occur on a timely basis and adheres to contractually binding conditions.
• Data Maintenance
• Accurately and consistently documents the audit results in the hospital information system.
• Compliance
• Ensures compliance with all state and federal billing regulations and reports any suspected compliance issues to your respective supervisor/manager.
• Contracting Data Trend Identification
• Identifies trends relating to contracting data causing underpayments and work with supervisor/manager to get these issues addressed with responsible parties.

QUALIFICATIONS

• Preferred Associate’s Degree
• Required High School Diploma/GED
• 2 years Patient Accounting, specifically billing, collections, customer service, or cash application Required
• 1 year Working knowledge of Microsoft Office Applications, Medical and Managed Care Contract terminology, and demonstrated knowledge of Revenue Cycle procedures. Previous auditing experience Preferred

Please refer the Job description for details