Description:

Works under the supervision of the Commercial Contracts Managed Care (CCMC) Supervisor. Analyzes and interprets Commercial contract language, terms, conditions and responsibility matrices. Performs telephone and written follow-up with insurance companies, third party payers, worker's compensation payers, medical groups, outside hospitals, and physician's offices to ensure timely payments of inpatient and outpatient hospital bills in accordance with the terms and conditions of each contract and/or insurance company policies. Ensures that payers adhere to compliance laws regarding timely processing of claims. Has a strong understanding of Managed Care and insurance company payment principles, rules, and regulations to perform reimbursement from both the third party and patient perspectives. When working with individual payers on an account-by-account basis, determines if payer needs additional information, identifies barriers, or secures payment dates. Responsible for following through with requested information as needed in order to remove payment barriers. If unable to remove barriers, elevates the account to either Management or Payer Management. Develops collection recovery strategies with each payer. Must aggressively pursue each outstanding account to reach maximum reimbursement and closure. These services may be provided for both the hospitals. Reviews appeals and denials Audit collections and review aging reports

Skills:

collector, healthcare, medical, commercial, insurance, medicare, advantage, medical collections, medical insurance billing, medical billing and coding

Top Skills Details:

collector, healthcare, medical, commercial, insurance, medicare, advantage

Additional Skills & Qualifications:

2 years experience with Hospital/Acute Care collections and payer collections/billing experience EPIC experience preferred but not required Denials management from cradle to grave. CCS, Medi-Cal experience Cancer treatments, Proton Therapy charges

We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

About the Company:
TEKsystems

About TEKsystems:

• We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.
• The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

Company Size:
5,000 to 9,999 employees

Industry:
Staffing/Employment Agencies

Founded:
0

Website:
https://www.teksystems.com/en/