Underpayment & Overpayment Collector – Healthcare

Job Summary

The Underpayment & Overpayment Collector – Healthcare (REMOTE) 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.

As a Underpayment & Overpayment Collector at Community Health Systems (CHS) - PCCM, you’ll play a vital role in supporting our purpose to help people get well and live healthier by providing safe, quality healthcare, building enduring relationships with our patients, and providing value for the people and communities we serve. Our team members enjoy a robust benefits package including medical, dental and vision, insurance, and 401k.

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.
• 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.

We know it’s not just about finding a job. It’s about finding a place where you are respected, valued and where your work is purposeful and fulfilling. A place where your talent is recognized, professional development is encouraged and career advancement is possible.

The Payment Compliance and Contract Management (PCCM) team plays a critical role in ensuring that payments are made according to contractual agreements and regulatory requirements. The team oversees the full contract lifecycle, focusing on analyzing reimbursement discrepancies, improving revenue cycle processes, and ensuring compliance with contract terms to support financial accuracy and operational efficiency.

Community Health Systems is one of the nation’s leading healthcare providers. Developing and operating healthcare delivery systems in 40 distinct markets across 15 states, CHS is committed to helping people get well and live healthier. CHS operates 71 acute-care hospitals and more than 1,000 other sites of care, including physician practices, urgent care centers, freestanding emergency departments, occupational medicine clinics, imaging centers, cancer centers and ambulatory surgery centers.

Originally posted on Himalayas