Mar 17, 2019

Lead Medical Collections Specialist

  • HCA Healthcare
  • Sarasota, FL, USA

Job Description

SHIFT: No Weekends

SCHEDULE: Full-time

HCA has been recognized as a World's Most Admired Company in the Health Care Medical Facilities Industry by Fortune Magazine. The Ambulatory Surgery Division of HCA operates and jointly owns with physicians 130+ surgery centers across the United States. Our cases are performed Monday-Friday which means NO nights, NO weekends, or On-call will be required.The size of our surgery centers naturally creates a culture where everyone knows one another with a shared focus on providing the best possible experience for those that we serve. We are currently in search of additional members to join our team!

We value you and your future. We provide multiple health insurance plan options, tuition reimbursement, and many more programs to cover a wide variety of today's life and family needs. In addition to your salary and health insurance benefits, HCA provides a matching 401k as well as an Employee Stock Purchase Plan (ESPP). Members of HCA receive consumer discounts on cell phones, hotels, rental cars, and many others. Interviews are being set immediately, you are encouraged to apply today!

GENERAL SUMMARY OF DUTIES: Contributes to the company completing the follow-up and collection from third party payers and self pay accounts to enhance cash flow and obtain associated reimbursement based on established contracts.

  • Performs follow up activities on all accounts to ensure prompt payment.
  • Maintains daily queue on desktop.
  • Identifies and corrects any coding or billing problems from EOBs.
  • Monitors insurance claims by running appropriate reports and contacting insurance companies to resolve claims that are not paid in a timely manner.
  • Prepares accounts for rebilling and for filing secondary insurance; sends to carrier with necessary documents, as needed.
  • Completes filing and follow-up on insurance denials with coder and physicians to obtain reimbursement.
  • Handles patient and insurance inquiries.
  • Updates the patient account record to identify actions taken on the account.
  • Updates AdvantX using daypack and re-files claims, as required.
  • Assigns Bad Debt accounts to Collection Agency as approved by BOM.
  • Acts as a liaison in collection of third party accounts, as required per Center practices.
  • Completes the reconciliation of accounts that are turned over to outside agencies.
  • Administers Center contracts with third party payers including Medicare and Medicaid, in accordance with facility practices, as determined through facility processes.
  • Notifies BOM/Administrator of contractual issues that are contrary or inconsistent with contract language.
  • Negotiates payment plans on self pay accounts utilizing established policies regarding Settlement Discounts.
  • Completes weekly reporting to BOM and Administrator involving collections.
  • Responsible for achieving and maintaining accounts receivable days.
  • Responsible for the reduction and maintenance of bad debt.
  • Performs reviews and turnovers of aged accounts to an outside collection agency for 1st placements and bad debt.
  • Follows Best Practices regarding initial follow-up at 21- 28 days for insurance claims and subsequent follow-up every 14-21 days.
  • Answers telephones.
  • Attends required meetings and participates in committees.
  • Provides business office and admissions back up as needed.
  • PC Skills - Demonstrates proficiency in Microsoft Office (Excel, Word, and Outlook) applications; knowledge of, or ability to learn, AdvantX - Accounts Receivable System, Smart, HOST and other systems as required. Demonstrates ability to type on PC keyboard.
  • Knowledge of commercial, Medicare, Medicaid, HMO/PPO, Tricare insurance operating procedures and contracts, and basic medical terminology.
  • Minimum (1) year of experience in a medical office setting (i.e. ambulatory surgery center, hospital, doctors office) highly preferred.
  • Knowledge of managed care payers and medical terminology (preferred).
  • Basic Life Support (BLS) may be required as per facility standard.
Company Description:

At its founding in 1968, Nashville-based HCA was one of the nation's first hospital companies. Today, we are the nation's leading provider of healthcare services, a company comprised of locally managed facilities that includes about 165 hospitals and 115 freestanding surgery centers in 20 states and England and employing approximately 204,000 people. Approximately four to five percent of all inpatient care delivered in the country today is provided by HCA facilities. Milton Johnson serves as Chairman and Chief Executive Officer of HCA.

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