Medical Insurance Collector II - Full-time / Part-time

Our client, Medtronic, the world’s leading medical technology company is looking for experienced Medical Collectors for their Patient Financial Services(PFS) department. As a key member of the Patient Financial Services (PFS) customer care team, responsible for all aspects of billing, credit and collection activities including customer service.

Following prescribed procedures and desk guidelines, performs a variety of collection tasks relating to general health care guidelines to collect amounts owed for pump and/or supply orders. Verifies accuracy of statements (patient and payer related) as well as other health care financial accounting documentation or records. Enters data into computer systems using defined computer resources and programs. Compiles data and prepares a variety of reports. May reconcile records with PFS team members and leaders; communicates with external vendors and customers (including representatives of health plans/payors.) Recommends actions to resolve discrepancies; investigates questionable data.

*Position Responsibilities:
(7-10 most important)

Initiates follow-up activities with third-party payers regarding open claim balances; makes written and verbal inquiries to payers. Analyzes and problem solves account issues to full resolution.

Reconcile claims/accounts to complete resolution, performing adjustment requests and updating patient accounts/claims online, utilizing appropriate transactions and consistently formatted notes that support future collection efforts and inquiries at both the insurance and customer (ie. selfpay) levels.

Provides support for inquires from internal and external customers regarding account/claim status. Maintains updated information on patient accounts.

Handles internal and external customer inquiries regarding account status and account history.

Performs eligibility verifications on patient accounts as new insurance plans/carriers are identified; updates information on expired insurance plans/carriers.

Researches issues off-line as needed with payor/patient; conducts follow-up calls with customers, initiating conference calls between insurance carrier and patients to resolve customer concerns.

Researches and initiates refund requests due to overpayments by payer and/or patient.

Determines when claims/accounts are deemed uncollectable; recommends and initiates bad debt write-offs procedures.

Meets or exceeds key performance indicators measuring productivity, quality, and service level as defined by Senior Management.

Qualifications / Requirements
High school diploma or GED
2+ years billing and/or collections experience in a medical group, health care company, or hospital setting
Working knowledge of various insurance plans offered by both government and commercial insurances (PPO, HMO, EPO, Medicaid, HRAs, etc).
Demonstrated ability to read and understand the information provided on EOBs, remittance advices, and other insurance correspondence.
Working knowledge of medical billing and collections terminology – CPT, HCPCS, and ICD-9 coding.
Working knowledge and understanding of HIPAA guidelines.
Knowledge and experience with MS Office suite (Word, Excel, Outlook)
Good customer service skills with ability to interact with both internal and external customers, i.e. patients, insurance payers, doctors, internal departments
Ability to handle customer and insurance company calls in a professional manner with customer-friendly focus and attention to detail in resolving issues
Proficiency in using a computer to navigate through multiple screens and programs at the same time in order to facilitate problem solving, and to give and receive information

MEDICAL COLLECTIONS, CUSTOMER SERVICE, MEDICAL TERMINOLOGY, EOB's