Description
Contact patients and insurers to resolve delinquent medical accounts and unpaid claims. Post and reconcile payments, set up payment plans, send statements and notices, correct billing issues or submit appeals, escalate to bad-debt agencies when required, and document all actions in compliance with HIPAA, FDCPA, and payer regulations.
- • Receive and post patient and insurance payments, ERAs/EOBs, and adjustments to accounts.
- • Work aging reports and payer worklists to identify and prioritize delinquent balances and denied claims.
- • Document all contacts, financial assessments, and collection actions in the practice management/EMR system.
- • Notify patients of past-due balances by phone, mail, or secure digital channels and request payment.
- • Review reasons for nonpayment, coverage details, and patient responsibility with patients or guarantors.
- • Educate patients on payment options, financial assistance, charity care, and HSA/FSA use.
- • Secure commitments to pay and collect payments in a compliant, compassionate manner.
- • Respond to billing inquiries and prepare routine collection, A/R, and denial metrics reports.
- • Update demographics, verify insurance eligibility, and flag bankruptcy, deceased, or returned-mail accounts.
- • Establish and maintain payment plans based on financial screening; obtain authorization for recurring payments.
- • Negotiate settlements, discounts, or write-offs within policy and escalate when approvals are needed.
- • Verify and update contact information using skip tracing tools and returned-mail workflows while protecting PHI.
- • Follow internal escalation paths and send required notices before placing accounts with bad-debt agencies or legal review.
- • Answer patient and payer questions about statements, EOBs, coverage, coding, and balances.
- • Follow up with insurers on unpaid or denied claims, correct coding or billing errors, and submit timely appeals with documentation.
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Tasks & skills:
O*NET occupational data (work activities, skills, knowledge).
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Last reviewed: Jan 2026
