Collection Coordinator

POSITION SUMMARY: The Collections Coordinator is responsible for performing all collections functions after claims have been submitted and processed. This role involves proactive follow-up with payers, meticulous denial management, and accurate account reconciliation to maintain a healthy accounts receivable (AR).

ESSENTIAL RESPONSIBILITIES AND DUTIES INCLUDE BUT ARE NOT LIMITED TO THE FOLLOWING:

• Executes targeted follow-up on outstanding accounts with Medicare, Medicaid, and commercial carriers based on AR aging reports to facilitate timely payment.
• Thoroughly researches the cause of payment denials (e.g., lack of authorization, documentation errors, untimely filing) and executes the necessary steps for resolution, correction, and resubmission or appeal.
• Prepares and submits formal appeals for denied claims, gathering required documentation (clinical and administrative) to overturn the payer's initial decision.
• Accurately reconciles posted payments with expected reimbursement, identifying discrepancies and contractual short-pays that require further follow-up.
• Manages the patient portion of collections, including generating and mailing statements, and communicating with patients regarding payment plans in a professional and compliant manner.
• Documents all collection activities, communications with payers, and status updates on the patient's account within the EMR system clearly and accurately.
• Reports common denial codes and collection roadblocks to the Billing Lead or Director of RCM to help identify and resolve upstream process issues.
• Other appropriate services and special projects as assigned.

The above statements are only meant to be a representative summary of the major duties and responsibilities performed by incumbents of this job. The incumbents may be requested to perform job-related tasks other than those stated in this description.

QUALIFICATIONS & REQUIREMENTS FOR THE POSITION:

• Minimum of 1 year of experience in medical collections, accounts receivable follow-up, or denial appeals, with experience in Home Health or Hospice preferred.
• Solid working knowledge of reading and interpreting EOBs (Explanation of Benefits), RAs (Remittance Advices), and payer correspondence.
• Proven ability to submit claims and track payment status through payer portals and a dedicated EMR system.
• Familiarity with the Medicare appeals process (e.g., Redetermination).