Collection Representative
Mass General Brigham (Enterprise Services), Somerville, MA, United States
Principal Duties and Responsibilities
Contact the guarantor for accounts in assigned work queues with the goal of clearing the accounts in a timely manner. Initial contact is by phone, which may require leaving a message that meets privacy and security guidelines.
Respond to patient/guarantor concerns during any contact. These concerns may span a wide range of issues including payer denials, coding accuracy, secondary billing, coordination of benefits, verification of co‑payments/co‑insurance/deductibles and verification/updates to demographic/insurance information. The overall goal is to validate the guarantor balance and ensure that the guarantor understands the reasons for the balance.
Representatives must be fully versed in MGB Credit & Collection Policy and Financial Assistance Policy and must inform patients of all assistance available to them when making payment arrangements, processing payments, and initiating financial assistance applications, while ensuring compliance with MA collections regulations.
Maintain assigned guarantor payment plans to ensure that payments are made regularly and resolve issues with suspended or rejected payment methods attached to auto‑pay payment plans. Follow up on assigned accounts which may require that the patient be contacted to update their payment plan, including adding new accounts to the payment plan.
Begin designated guarantor contacts by creating a ‘CRM’ folder to classify the reason for the contact, seek to identify root cause(s) of guarantor/patient inquiries, and document them as part of the CRM process. Follow up on individual issues until they are completed and flag unusual items or trends for supervisor or manager review.
Access information from a range of supporting systems or information sources—including document imaging (OnBase), eligibility verification systems (NEHEN, payer websites) and other document backup (SharePoint)—to identify root cause issues.
Provide timely, professional, and accurate account review, analysis, and resolution of patient inquiries through review of account history, third‑party billing activity and analysis of payments and adjustments, and seek expert assistance from other departments as needed.
Resolve issues during the initial patient contact whenever possible, verify the patient’s fiscal and demographic information at every opportunity, and make appropriate updates to various billing systems to ensure claims are processed appropriately.
Use the department SharePoint tool as needed to initiate a privacy incident.
Understand liability claims, legal basics, medical terminology, a general knowledge of the MGB network hospitals and key industry issues.
Follow guidelines to correctly assess HSN surcharges for applicable services and respond to guarantor questions regarding the nature of the surcharge.
Support and demonstrate the values of PHS and affiliates by conducting work activities in an ethical manner with integrity, honesty, and confidentiality; represent a team perspective and willingness to collaborate with others; and promote a cooperative team environment with enthusiasm.
Specific Accountabilities
Work a minimum of 5 guarantor accounts (MRN) per hour for every hour logged into the Epic (assigned work queue) system.
Maintain 100% productivity on a monthly average.
Maintain an average quality assurance score of 90% on all reviews.
Qualifications
High school diploma or GED equivalent required.
Associate’s degree preferred but not required.
Epic billing systems knowledge preferred.
Bilingual Spanish/English preferred.
Effective communication, organizational and problem‑solving skills required.
1–3 years’ relevant experience in customer service or collections in a health care setting desired.
A combination of education and experience may be substituted for requirements.
Work Conditions
Monday‑Friday Eastern Business hours required for this remote role.
Quiet, secure, stable, compliant workstation required.
Mass General Brigham Incorporated is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment.
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Contact the guarantor for accounts in assigned work queues with the goal of clearing the accounts in a timely manner. Initial contact is by phone, which may require leaving a message that meets privacy and security guidelines.
Respond to patient/guarantor concerns during any contact. These concerns may span a wide range of issues including payer denials, coding accuracy, secondary billing, coordination of benefits, verification of co‑payments/co‑insurance/deductibles and verification/updates to demographic/insurance information. The overall goal is to validate the guarantor balance and ensure that the guarantor understands the reasons for the balance.
Representatives must be fully versed in MGB Credit & Collection Policy and Financial Assistance Policy and must inform patients of all assistance available to them when making payment arrangements, processing payments, and initiating financial assistance applications, while ensuring compliance with MA collections regulations.
Maintain assigned guarantor payment plans to ensure that payments are made regularly and resolve issues with suspended or rejected payment methods attached to auto‑pay payment plans. Follow up on assigned accounts which may require that the patient be contacted to update their payment plan, including adding new accounts to the payment plan.
Begin designated guarantor contacts by creating a ‘CRM’ folder to classify the reason for the contact, seek to identify root cause(s) of guarantor/patient inquiries, and document them as part of the CRM process. Follow up on individual issues until they are completed and flag unusual items or trends for supervisor or manager review.
Access information from a range of supporting systems or information sources—including document imaging (OnBase), eligibility verification systems (NEHEN, payer websites) and other document backup (SharePoint)—to identify root cause issues.
Provide timely, professional, and accurate account review, analysis, and resolution of patient inquiries through review of account history, third‑party billing activity and analysis of payments and adjustments, and seek expert assistance from other departments as needed.
Resolve issues during the initial patient contact whenever possible, verify the patient’s fiscal and demographic information at every opportunity, and make appropriate updates to various billing systems to ensure claims are processed appropriately.
Use the department SharePoint tool as needed to initiate a privacy incident.
Understand liability claims, legal basics, medical terminology, a general knowledge of the MGB network hospitals and key industry issues.
Follow guidelines to correctly assess HSN surcharges for applicable services and respond to guarantor questions regarding the nature of the surcharge.
Support and demonstrate the values of PHS and affiliates by conducting work activities in an ethical manner with integrity, honesty, and confidentiality; represent a team perspective and willingness to collaborate with others; and promote a cooperative team environment with enthusiasm.
Specific Accountabilities
Work a minimum of 5 guarantor accounts (MRN) per hour for every hour logged into the Epic (assigned work queue) system.
Maintain 100% productivity on a monthly average.
Maintain an average quality assurance score of 90% on all reviews.
Qualifications
High school diploma or GED equivalent required.
Associate’s degree preferred but not required.
Epic billing systems knowledge preferred.
Bilingual Spanish/English preferred.
Effective communication, organizational and problem‑solving skills required.
1–3 years’ relevant experience in customer service or collections in a health care setting desired.
A combination of education and experience may be substituted for requirements.
Work Conditions
Monday‑Friday Eastern Business hours required for this remote role.
Quiet, secure, stable, compliant workstation required.
Mass General Brigham Incorporated is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment.
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