Follow Up – Collections Follow-up and collect on accounts for all payors, including Medicare, Medi-Cal, commercial, guarantor, and other contracted payors. Primary follow-up assignment is to facilitate payment for accounts previously billed. Review each patient’s case, correspondence, and current computer data to determine possible payment problems. Maintain “portfolio” of such accounts with optimum cash collections, adjustments and closures. Perform follow-up on all outstanding insurance claims. Document all activity. Manage and process assigned computerized (i.e., ETM, etc.) or manual worklist in a timely manner to ensure that MSO CBO achieves its overall collection standards and quality measures. Call appropriate third-party contacts and establish specific reimbursement status, i.e. reason for any discrepancy between expected and actual reimbursement amount and date of issuance. Be aware of courtesy rates and/or courtesy adjustments. Adjustments / Write-Offs / Updates Submits necessary adjustments using the correct debit or credit transaction in order to correct account balance and/or claim totals prior to submission. Submits adjustments with appropriate codes. When circumstances warrant, transfers all or parts of a patient account charges to the correct account. Submits charge corrections and/or combines charges correctly via patient accounting system. Updates case / payer data and documents the reason for the updates; requests rebills as necessary. Submits adjustment requests to immediate Supervisor for review and approval. Applies proficiency in understanding and applying contractual terms of our Managed Care contracts (i.e., PPO, HMO, EPO, POS, Medi-Cal, Medicare, etc.). Applies knowledge of Cerner, AIDX/GE and other systems Demonstrates knowledge in various payor websites. System Folder Notes / Account Documentation Documents claim bill date, billed amounts, billing address, billing attachments, invoice number, expected payment, contractual amount, received payments, actual transplant date(s), type of transplant, pre and post periods for transplant days, and all pertinent billing data relevant to billing the claim. Documents in a clear, concise and grammatically correct manner in system folder notes. Uses appropriate collector comment codes.