HCA, Hospital Corporation of America Managed Care Collector - Urgent Care in Coppell, Texas


This position functions as a collector resolves claims for patients that use private insurance at the clinics. Collect on claims that are past due and work to minimize the managed care aging with focus on the over 90’s, 60’s and 30’s. Ensures all department goals are maintained.


  • Collect on past due claims by calling insurance companies and patients

  • Resubmit HCFA 1500 claims as required by the insurance companies

  • Minimize denials by communicating insurance trends

  • Research notes from web chart and send to the insurance company if necessary

  • Establish and maintain positive provider relations with insurance representatives

  • Assist in resolving claim-processing problems by working with provider relations

  • Minimize the “over 30 day” claims on the insurance aging

  • Ensure network fee schedules are followed regarding claims processing

  • Work and research the “current” explanations of benefits

  • Research the “posted payments” explanations of benefits to determine if the patient owes the balance and needs to receive a statement

  • Communicate effectively employer trends to ensure instruction sheets are correct

  • Communicates effectively insurance trends with supervisor

  • Document detailed and concise notes in computer software on every claim

  • Place alerts in patient’s accounts with detailed reason for patient balance

  • Ensures all department processes and procedures are followed

KNOWLEDGE, SKILLS, ABILITIES REQUIRED: * High School Diploma or equivalent

  • Minimum of 3 years work experience in medical collections

  • Knowledge of urgent care benefits and how claims are adjudicated

  • Strong understanding of managed care contracts, CPT, ICD 9-CM/ICD-10-CM, and HCPCS codes

  • Understanding of managed care terminology and practices, experience with PPO and HMO networks and payers associated with these networks

  • Understands all commercial contractual rates

  • Strong understanding of specific plan benefits for urgent care

  • Strong knowledge of reading and interpreting EOB’s

  • Understanding payer website and retrieval of information and EOB’s

  • Excellent verbal communication skills, telephones skills, and strong sense of urgency

  • Ability to develop positive relationships with insurance representatives

  • Ability to handle multiple tasks effectively

  • Ability to grasp basic computer skills

  • Good telephone skills and ability to do complex and sometime aggressive collection activities

  • Fast paced work style to process and work significant quantities of claims

  • Ability to grasp basic computer skills with patient processing software.

  • Good mathematical ability

  • Highly organized and meticulous

  • Solid research and problem solving skills

  • Professional image and excellent customer service skills.

  • Proficient in the use of the computer and practice management system

  • Solid research and problem solving skills

  • Knowledge of and adherence to HIPAA regulations and guidelines

  • Strong sense of urgency in a fast paced environment

  • Practice and adhere to the company Mission Statement and Excellence Strategy

  • Work professionally, effectively, and efficiently in a team environment with patients, leadership, clinical staff, and HO employees

Title: Managed Care Collector - Urgent Care

Location: Texas-Coppell-CareNow - Primary Health Inc

Requisition ID: 24900-51493