POSITION SUMMARY
EVP Eyecare is a privately held, portfolio company of The Cortec Group. Based in Denver, Colorado, EVP owns and operates a super-regional network of eyecare practices and surgical centers that conduct business under premier brands in Colorado, Texas and Arizona. We believe that delivering on an outstanding patient experience starts with building an outstanding employee experience.
Our mission is to improve people’s lives through better vision and outstanding patient experiences.
ESSENTIAL DUTIES AND RESPONSIBILITIES
The essential functions include, but are not limited to the following:
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Compile the information necessary to perform A/R collections.
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Locate and notify customers with delinquent accounts or if any additional information is needed.
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Ensure inbound calls are handled timely, efficiently, and appropriately.
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Make outbound calls, as needed, for collections and revised billing to payers.
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Explain patient balances and collect payment from patients.
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Communicate to manager any concerns and issues impacting collections of outstanding receivables or the company.
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Prepare list of accounts to be sent to collection agency.
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Work Edits and Errors in System regarding patient A/R.
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Prepare required reports including A/R aging.
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Resolve discrepancies in a timely fashion, establish clear payment schedules.
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Prepare accounts to be written off and turned over to manager.
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Answer incoming A/R inquiries and follow up.
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Notify manager regarding any problems or risky clients.
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Make outbound calls or research online notes to various types of payers i.e., patients, insurance companies and providers to address and resolve delinquent accounts in the assigned queue.
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Review outstanding balances to determine if financial responsibility is assigned to appropriate party.
- Note accounts with current actions, every time the account is reviewed.
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Report daily productions to manager.
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Meet required production numbers as set by manager, 40-60 claims per day.
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Properly appeal cases when necessary and according to carrier and company policy.
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Advise manager of medical necessity denials due to non-compliance of insurance medical policies.
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Maintain a professional approach with confidentiality. Assure protection and privacy of health information as attained through written, electronic or oral disclosures.
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Seek guidance and remain knowledgeable of, and comply with, all applicable federal and state laws, as well as company policies and procedures.
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Other duties as assigned.
MINIMUM QUALIFICATIONS (KNOWLEDGE, SKILLS, AND ABILITIES)
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High School Diploma or equivalent required, Bachelor’s Degree preferred.
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Coding Certificate preferred.
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Experience in customer relations, referral processing, and/or the TRICARE program preferred.
- Professional appearance and demeanor are required.
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Knowledge of insurance plans and providers.
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Knowledge of claims and billing.
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A commitment to excellent customer service as well as a positive proactive attitude.
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Excellent communication and verbal skills including proper grammar.
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CPT, HCPCS, and ICD-10 knowledge.
PHYSICAL DEMANDS AND WORK ENVIRONMENT
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the functions. While performing the duties of this position, the employee is regularly required to talk or hear. The employee frequently is required to use hands or fingers, handle or feel objects, tools, or controls. The employee is occasionally required to stand; walk; sit; and reach with hands and arms. The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this position include close vision, distance vision, and the ability to adjust focus. The noise level in the work environment is usually low to moderate.
NOTE
This job description in no way states or implies that these are the only duties to be performed by the employee(s) incumbent in this position. Employees will be required to follow any other job-related instructions and to perform any other job-related duties requested by any person authorized to give instructions or assignments. All duties and responsibilities are essential functions and requirements and are subject to possible modification to reasonably accommodate individuals with disabilities. To perform this job successfully, the incumbents will possess the skills, aptitudes, and abilities to perform each duty proficiently. Some requirements may exclude individuals who pose a direct threat or significant risk to the health or safety of themselves or others. The requirements listed in this document are the minimum levels of knowledge, skills, or abilities. This document does not create an employment contract, implied or otherwise, other than an “at will” relationship.