MEDNAX has grown from a single medical practice to a trusted health solutions partner with more than 10,000 employees and a presence in 50 states. Through our family of companies, we provide:
- physician services spanning the continuum of patient care
- revenue cycle management solutions
- performance improvement consulting
We invite you to grow with us and help shape the future of health care.
The Collection Administrator is responsible for effective and efficient accounts receivable management of assigned payers. The collections efforts on outstanding accounts includes; telephone contact with payers, patients and parents, work collection reports and correspondence, audit accounts, appeal denied claims as necessary, update accounts as necessary, identify carrier related denial trends and meet departmental productivity standards. Performs required tasks on GPMS, OBR, Master Database, electronic claims vendors' software, Medifax, Excel, Word and internet to access payor websites.
Make necessary telephone, electronic or written contact.
- Contact payers to check claim status and reimbursement.
- Contact parents to obtain accurate insurance information.
- Phone appeals on denied claims.
- Contact payer regarding carrier issues.
- Provide Call Center or Customer Service Coordinator backup as needed.
- Send appropriate letters.
Consistent follow-up on outstanding accounts by working collection reports and correspondence.
- Not Worked Report – Summarizes outstanding accounts not worked within the department's guidelines.
- 1499 Report – Identifies registered Commercial accounts that have been paid as Managed Care.
- Denial Report – Identifies specific denials posted from EOB's received.
- Residual Report – Identifies balances remaining after payer has made a payment.
- Queue Summary Report – Identifies the accounts that are scheduled to be worked for a given day.
- Clearinghouse Reports – Identifies specific denials for claims submitted electronically.
- Review and work all daily correspondence received from patients and payers.
Perform audits on accounts when needed.
- Review accounts for accuracy (ie; payments have been posted correctly, appropriate adjustments have been made, etc.).
- Process refunds for overpayments made by payers and patients.
- Process adjustments as necessary (ie; contractual, good faith, settlement, etc.).
Appeal denied claims via mail or telephone.
- Request Accounts Receivable Status Reports when a denial trend has been identified.
- Review accounts receivable report detail for denial trends.
- Obtain Medical Records from Associates/Clinics and send them to the payer.
- Review diagnosis and procedure codes with the Coding Department.
- Submit problem packs or appeals to specific payers. Ensure confirmation of receipt of claims.
Update accounts as necessary
- Update accounts in GPMS with information obtained through correspondence and telephone (ie; insurance, authorization, address, baby's name, etc.).
- Completes appropriate account maintenance by ensuring that the correct statement groups, financial class, and payer codes are current and timely.
Identify carrier related denial trends.
- Review denial reports (GPMS Denial, clearinghouse reports, Not Worked) for payer trends.
- Elevate problems to department Manager.
Meet or exceed required departmental productivity standards on a consistent basis.
- Average of quality and quantity productivity standards must meet or exceed 94%.
Performs a variety of other collection duties.
- Assists on various special projects as determined by the Manager.
- Always meets deadline dates and times on assigned projects.
- Work overtime in mandatory situations.
Maintain strict confidentiality in accordance with HIPAA regulations and Company policy.
Any patient private health information (PHI) must not be divulged on any account except to payers that need the information in order to process the claim for payment.
Presents a positive, professional appearance and conveys a professional demeanor in the performance of assigned duties.
Performs other job-related duties within the job scope as requested by Management of Patient Accounts.
Embodies the principles of the corporate Mission Statement and Philosophy at all times.
- Represents the corporation in a positive fashion and makes all individuals feel as comfortable as possible.
- Conducts all business in a professional manner maintaining respect for individuals at all times.
Complies with departmental and company-wide policies and procedures.
- Maintains constant awareness of potential safety hazards insuring necessary safety precautions.
- Reads and complies with established policies and procedures.
- Associate's degree (A. A.) or equivalent from two-year college or technical school; or one to two years related experience and/or training; or equivalent combination of education and experience.
- Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to calculate figures and amounts such as discounts and percentages.
- Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form. Ability to define problems, collect data, establish facts, and draw valid conclusions.
MEDNAX IS AN Equal Opportunity Employer
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status