Underpayment & Overpayment Collector – Healthcare (REMOTE)

Job Summary The Payment Compliance & Contract Management (PCCM) Collector is responsible for the timely and efficient resolution of underpaid and overpaid accounts. This role involves managing account follow-up, analyzing trends, collaborating with internal departments, and ensuring accurate reconciliation of account balances. The PCCM Collector assists in optimizing revenue cycle processes and maintaining compliance with contractual agreements. Essential Functions Manages account follow-up for underpaid and overpaid claims, escalating unresolved issues internally as needed to achieve resolution. Reconciles account balances and adjustments to ensure accurate financial status and compliance with contractual terms. Resolves underpayments by engaging in daily communication with payers and negotiating payment discrepancies. Identifies and analyzes trends in underpayments, overpayments, denials, and revenue opportunities to recommend process improvements. Evaluates and interprets contract reimbursement details, providing feedback and insights to the department to enhance revenue cycle performance. Collaborates with financial and clinical departments to address account discrepancies and ensure effective revenue management. Reviews contract validation, updates, and provides interpretation to support accurate claim processing and collections. Ensures thorough and accurate validation of account analysis before distribution, maintaining compliance with policies and procedures. Performs other duties as assigned. Maintains regular and reliable attendance. Complies with all policies and standards.

Qualifications

H.S. Diploma or GED required Associate Degree or higher preferred 1-2 years of experience in healthcare collections, revenue cycle, or contract management required Familiarity with payer contracts and healthcare reimbursement methodologies preferred Knowledge, Skills and Abilities Strong analytical and problem-solving skills. Proficient in understanding and interpreting payer contracts and reimbursement terms. Effective communication and negotiation skills. Ability to work independently and manage multiple priorities in a fast-paced environment. Proficiency in healthcare billing software, Google Suite, and Microsoft Office Suite, especially Excel. Attention to detail and high degree of accuracy in reconciliation and analysis.