Job Description

CNSO is a vibrant, well-established, neurosurgery, spine surgery, orthopedic spine surgery, pain management and physical therapy practice, with multiple office locations throughout Northern New Jersey. Due to continued expansion, CNSO has an exciting opportunity to join its revenue cycle department in its Wayne location. The medical collector should have proficiency and knowledge regarding claims adjudication process, individual insurance policies, CMS guidelines, NCCI edits, and the ability to effectively and professionally communicate with insurance carriers and fellow staff members both verbally and in writing. This Medical Collector position will be responsible for the follow-up and payment of claims. CNSO provides a two-month orientation and training process. The right candidate can work both independently and in a team setting. The revenue cycle department is very organized and has routine and regular educational weekly meetings.

Duties & Responsibilities:

• Timely management of assigned medical claims, aging reports, and correspondence.
• Consistently communicate with insurance companies to address denials, corrected claims, and receipt of appeals.
• Proactively ensure timely and accurate processing of claims.
• Utilizes Navinet, Optum, and Availity to understand the status of claims.
• Adheres to policies and procedures.
• Accurately identifies the reason for payor denials.
• Detailed appeal writing that targets the reason for the denial.
• Identifies the cause of clearinghouse rejections.
• Ensure the primary payor’s claim is always sent to the secondary payor and verify that both parties pay the contracted rate.
• Answers and resolves all incoming calls, faxes, and emails promptly.
• Achieves goals established by the Revenue Cycle Manager.
• Duties as assigned.

· Experience/Training/Education:

• High School Diploma or GED

· **Must have 3+ years of Medical Collections experience**

• Strong Experience in collecting for Physical Therapy, office visits, plastics, or surgery preferred.
• Experience with in and out of network claims along with NJ PIP and WC
• Posting knowledge also valued

Knowledge/Skills/Abilities:

• Ability to research payor websites and apply insurance guidelines
• Medicare Medical Billing
• Outlook, Word, Excel
• EMRs such as EclinicalWorks

Benefits:

• Healthcare Plan
• Dental and Vision Plan
• PTO
• 401K

· Work Location:

• One location-Wayne. NJ
• Work Remotely, No
• Job Type: Full-time

Eligible for semi-annual bonus based on performance evaluation.

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