Job Title: Medical Collector – Multi-Specialty ASC Center

Department: KPO (Knowledge Process Outsourcing)
Domain: Healthcare Services
Location: [Insert Location]
Experience Level: 2+ years

About GrowBeyond Tech:

GrowBeyond Tech Pvt. Ltd. is a premier IT and business consulting firm committed to delivering exceptional services across industries, including healthcare. Our KPO division specializes in optimizing operational efficiencies for multi-specialty Ambulatory Surgery Centers (ASCs), ensuring streamlined processes and enhanced financial outcomes.

At GrowBeyond Tech, we value precision, collaboration, and innovation. Our team of medical collectors plays a crucial role in driving revenue cycle success by ensuring accurate claims submissions and effective collections. We invite individuals with a passion for healthcare operations to join our dynamic and inclusive environment.

Job Overview:

GrowBeyond Tech is seeking a skilled Medical Collector to support our multi-specialty ASC operations. As a full-time insurance claims revenue specialist, you will oversee and manage billing collections to ensure timely payments from patients and insurance organizations. Your role will involve researching claim denials, negotiating payment plans, and maintaining compliance with industry standards.

The ideal candidate will have experience with platforms like Availity, Waystar, Optum, and proficiency in HST EMR. The position requires working US-aligned hours to facilitate collaboration with insurance companies and US-based staff.

Responsibilities:

1. Billing and Claims Management:
   • Prepare and submit billing data and medical claims to insurance organizations and private payers.
   • Ensure the accuracy of submitted claims and follow up on unpaid or denied claims.
2. Patient and Client Engagement:
   • Research and contact clients or patients to inform them about overdue bills and accounts.
   • Negotiate payment plans with patients facing financial challenges to settle overdue bills.
3. Claims Investigation and Resolution:
   • Contact insurance companies to determine the status of claims and investigate reasons for denials.
   • Resolve discrepancies and ensure all posted payments are accurate and comprehensive.
4. Collection Monitoring and Reporting:
   • Monitor missed payments and settle financial discrepancies promptly.
   • Maintain cash spreadsheets, update rate changes, and generate current collection reports.
5. Software and System Management:
   • Oversee and maintain billing software, including platforms like Availity, Waystar, Optum, and HST EMR.
   • Ensure systems are updated with accurate financial data and patient records.
6. Compliance and Quality Standards:
   • Maintain quality results by adhering to established standards and regulations.
   • Involve legal authorities when necessary to address non-payment issues.

Key Tasks:

• Review patient accounts for completeness and accuracy of billing.
• Update and monitor collection reports to track payment progress.
• Engage with insurance companies and patients to resolve billing issues.
• Ensure compliance with healthcare billing regulations and HIPAA standards.
• Stay informed on updates to billing software and industry practices.

Qualifications:

• Education: Bachelor’s degree in a related field or certification in medical billing and collections preferred.
• Experience: Minimum of 2+ years in medical billing and collections, with a focus on healthcare services.
• Preferred Skills:
  • Proficiency in HST EMR and familiarity with platforms like Availity, Waystar, Optum.
  • Strong understanding of medical claims processes and healthcare payer systems.
• Skills:
  • Excellent communication and negotiation skills.
  • High attention to detail and problem-solving abilities.
  • Ability to work US-aligned hours for effective collaboration.