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PBO Insurance Collector Job in Greenville, South Carolina

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Job Title: PBO Insurance Collector

Employer:Prisma Health
Specialties:Healthcare, group practice
Required Experience:1 to 2 years
Location:701 Grove Rd Greenville 29605, SC, US
Date Posted:10/15/2021
Prisma Health is seeking a FT PBO Insurance Collector. Position is based in Greenville, SC.

Responsible for collection process for outstanding insurance carrier claims in a timely manner. Investigates billing or collection problems and assists with resolution.


    A.  Identifies delinquent accounts, aging period and payment sources.  Processes delinquent unpaid accounts by contacting patients (if applicable) and third party reimbursers.

    B.  Works in assigned PCS work files 90% of the time and maintains standards of 250 invoices per week/50 per day, contacting third party payors for status of unpaid invoices greater than 45 98% of the time

    A.  Oversees claim processing and payments to third party providers.  Answers associated correspondence.

    B.  Sends denial letters on claims and follow-up on requests for information.

    D.  Audits and reviews claim payments reports for accuracy and compliance.

    E.  Researches and resolves claim  problems.

    F. Requests information needed (medical records, charge corrections) from physician offices as needed: maintains information until claim is paid, follows turnaround time within standards

    G. Requests posting corrections, refunds or adjustments as needed.

    H. Researches denied claims within two days 98% of the time

    I. Updates patient information, files insurance to correct carrier as needed, files corrected claims and additional information requested by carrier within two days of receipt 98% of the time

    J.  Appeals denied claims adhering to payer policy

    K.   Works all assigned claims within designated time frame to ensure timely and appropriate payment

    A.  Files hard copy secondary claims with primary EOB as needed

    B.  Requests records or pulls dictation to file workers comp claims as needed     

    C.  Refiles claims via vendor or hard copy as needed

    D.  Maintains required billing records, reports, and files.

    E.  Investigates billing problems and formulates solutions. 

    F.  Maintains and enhances current knowledge of assigned payers with regard to guidelines for billing


Click this link to apply online or cut and paste the URL in to your browser: https://careers.prismahealth.org/us/en/job/R1029241/PBO-Insurance-Collector-FT-Days

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