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Credit - Collections Clerk II

San AntonioMedtronic



ABOUT MEDTRONIC:
Together, we can change healthcare worldwide. At Medtronic, we push the limits of what technology can do to help alleviate pain, restore health and extend life. We challenge ourselves and each other to make tomorrow better than yesterday. It is what makes this an exciting and rewarding place to be.
We can accelerate and advance our ability to create meaningful innovations - but we will only succeed with the right people on our team. Let's work together to address universal healthcare needs and improve patients' lives. Help us shape the future.

DIABETES BUSINESS DESCRIPTION:
The Diabetes Group at Medtronic is part of Medtronic plc, the global leader in medical technology. We are committed to ongoing breakthrough developments in leading-edge technology, unrivaled service and support, and uncompromising leadership. Medtronic is working with the global community to change the way people manage diabetes. Together, we will transform diabetes care by expanding access, integrating care and improving outcomes, so people with diabetes can enjoy greater freedom and better health.

POSITION DESCRIPTION

As a key member of the Patient Financial Services (PFS) customer care team, the Credit and Collections Clerk II - Collections Specialist is responsible for all aspects of billing, credit and collection activities, including customer service with an objective of maximizing cash flow and keeping DSO to a minimum.

Following prescribed procedures and desk guidelines, performs a variety of collection tasks relating to general healthcare guidelines to collect amounts owed for pump and/or supply orders. Verifies accuracy of statements (patient and payor related) as well as other healthcare 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.

Executes on established departmental objectives and assignments which affect the immediate operation, but that also have full revenue cycle and ultimately company-wide financial impact.

POSITION RESPONSIBILITIES

? Initiates follow-up activities with third-party payors regarding open claim balances; makes written and verbal inquiries to payors. 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 (i.e. selfpay) levels.

? Provides support for inquiries 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 payor 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.

? Actively participates in team initiatives and in team status meetings.

? Additional team activities, projects, and work flow as assigned.

? Service Excellence:

o Works to identify ways to and initiate processes that work towards enhanced credit and collections, and improving service levels to both internal and external customers.
o Actively participates in process and service improvement activities.

BASIC QUALIFICATIONS

IN ORDER TO BE CONSIDERED FOR THIS POSITION, THE FOLLOWING BASIC QUALIFICATIONS MUST BE EVIDENT ON YOUR RESUME:

  • High School Diploma or GED

  • Minimum of 3 years billing and/or collections experience in a medical group, healthcare company/insurance, or hospital industry.

  • Experience with medical billing and/or collections terminology (i.e. CPT, HCPCS, and ICD-10 coding)

    DESIRED/PREFERRED QUALIFICATIONS

  • Experience with various insurance plans offered by both government and commercial insurances (PPO, HMO, EPO, POS, Medicare, Medicaid, HRAs, etc) and coordination of healthcare benefits, including requirements for referral, authorization and pre-determination.

  • Experience with reading and understanding the information provided on EOBs, remittance advices, and other insurance correspondence, and in calculating patient responsibility taking into consideration coverage and benefits, including referral, authorization, and/or pre-determination requirements, and contract terms.

  • Experience with reviewing and analyzing insurance payments, and/or payor adjudication of claims against contract terms and patient coverage and benefits.

  • Excellent customer service skills with ability to interact with both internal and external customers, i.e. patients, insurance payors, doctors, internal departments and handle in a professional manner with customer-friendly focus and attention to detail in resolving issues.

  • Experience with HIPAA guidelines and healthcare compliance.

  • Experience with MS Office suite (Word, Excel, Outlook), and internet and web site navigation.

  • Proficiency in navigating multiple screens and programs at the same time in order to facilitate problem solving, and other activities that require multi-tasking.

  • Ability to maintain composure, and to follow instructions and protocols when dealing with unfamiliar or unusual payor / customer issues.

  • Demonstrated ability to present information in a clear, concise, and grammatically correct manner both verbally and in writing.

  • Demonstrated collaboration skills (including active listening skills, presentation skills) and proven ability to work effectively in a diverse, inclusive organization and environment.

  • Demonstrated ability to accept and carry out oral and written instructions accurately.

  • Demonstrated ability to prioritize work, handling daily and multiple tasks to completion within the time allotted, while working as part of a team within a demanding environment.

  • Ability to prepare forms, spreadsheets, and graphs.

  • Experience in a payor or medical provider community that deal with all aspects of the revenue cycle.

  • Experience in a large corporate (even matrixed) environment

  • Internal candidates, minimum 4 months of experience working in Medtronic PFS department

  • Previous work experience with GE Centricity

    PHYSICAL JOB REQUIREMENTS

    The physical demands described within the Responsibilities section of this job description are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

    While performing the duties of this job, the employee is regularly required to be independently mobile. The employee is also required to interact with a computer, and communicate with peers and co-workers.

    While performing the duties of this job, the employee is regularly required to talk or hear, frequently required to sit and reach with hands and arms, and regularly required to stand, walk and use hands to finger, handle or feel.

  • Ability to sit, wear a headset, and work on the computer for extended periods of time.
  • Ability to sit/stand/walk 8 hours per day
  • Ability to hear and speak clearly
  • Ability to occasionally lift up to 10 lbs
  • Position is in a typical office environment
  • Ability to be flexible with working hours given adequate notice. Ability to work overtime as needed.
  • Travel up to 10%

    EEO STATEMENT:
    It is the policy of Medtronic to provide equal employment opportunity (EEO) to all persons regardless of age, color, national origin, citizenship status, physical or mental disability, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status, or any other characteristic protected by federal, state or local law. In addition, Medtronic will provide reasonable accommodations for qualified individuals with disabilities.

    This employer participates in the federal E-Verify program to confirm the identity and employment authorization of all newly hired employees. For further information about the E-Verify program, please click here: http://www.uscis.gov/e-verify/employees

    DISCLAIMER:
    The above statements are intended to describe the general nature and
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