Job Details:
The Central Business Office is currently seeking a Senior Medical Collector. The incumbent will workwith Aged Accounts Receivables. Ensure all information pertaining to demographics, insurance information, etc. on each encounter is correct so that proper parties are provided with information necessary to make prompt payment on account.Call insurance companies or access payer websites, contact attorneys, etc. on delinquent accounts and underpaid accounts to find out status of claim payment. If payments have not been received by a certain date, escalate calls up the chain of command with the carrier until resolution is achieved. Ensure that accurate insurance payments are being issued in a timely manner per Florida Prompt Pay Laws. Follow up on all denials with well written detailed appeal letters. Responsible for reviewing and understanding all aspects of the Explanation of Benefits received from the insurance companies and taking appropriate action when necessary including appealing all claims that are denied or underpaid, request for adjustments or refunds when applicable.• Understand reimbursement methodologies involving multiple procedure guidelines, add on codes, modifier 51 exempt codes, and fee schedule reimbursement versus. Advises the Supervisor of any trends insurance denials in order to identify problems with particular payors. This individual responds to inquires form patients and insurance carriers, over the telephone and in person. May serve as a team lead or subject matter expert to other employees. Has broad and deep knowledge of own area as well as related areas. Demonstrates sustained high level of proficiency in all aspects of job.
Minimum qualifications include a High School Diploma plus three years of experience in medical collections. Knowledge of medical terminology, ICD9 & CPT4 coding used for diagnoses and medical treatments. Proficient wit MS Office. Basic working knowledge of all modifiers, surgical modifiers in particular, CPT and ICD-9 coding and how these three items drive reimbursement.Knowledge of third party payor requirements, reimbursement rules, and laws and regulations that govern collection activities including the Florida Prompt Pay Law. Any appropriate combination of education, certifications, and/or relevant work experience may be considered.
At the University of Miami School of Medicine, patient safety is a top priority. As a result, during the Influenza ("the flu") season (September through April), the University of Miami School of Medicine requires all employees who provide ongoing services to patients, work in a location (all Hospitals and clinics) where patient care is provided, or work in patient care or clinical care areas, to have an annual influenza vaccination. Failure to meet this requirement will result in rescinding or termination of employment.UHealth-University of Miami Health System, South Florida's only university-based health system, provides leading-edge patient care powered by the groundbreaking research and medical education at the Miller School of Medicine...
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