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LEAD REIMBURSEMENT RECOVERY SPLST

H. Lee Moffitt Cancer Center

Location: 33612
Type: Full-Time, Non-Remote
Posted on: July 27, 2021
This job is no longer available from the source.
LEAD REIMBURSEMENT RECOVERY SPLST Administrative & Clerical Support Hours: 7 a.m. to 3:30 p.m. Day Shift - Full Time Paygrade/Wages/Salary Info: NE N20 - 17.7500 - 22.3500
Lead Reimbursement Recovery Specialist # Position Highlights: The Lead Reimbursement Recovery Specialist will act as a team leader and provide guidance and direction for daily collection activities, as well as assist team members in on-boarding, training and education in the pursuit of payment from Medicare and other Governmental, Commercial, HMO, PPO and other Third Party payers, as well as Medicaid and Medicaid HMO, according to policy and procedure. Leads will demonstrate and help ensure compliance in all collection practices, while obtaining payment for services in the most efficient, prompt and accurate manner possible. The Ideal Candidate: The ideal candidate will have experience working with one of the following: Aetna/Blue Cross/United and other commercial payors, #including eligibility inquiries and Denials Management.# Billing and claim submission experience, preferably on a UB04, is a plus. Or Medicare, Medicare Advantage and Medicaid, including eligibility inquiries via DDE or SPOT and Denials Management.# Billing and claim submission experience, preferably on a UB04, is a plus. # Responsibilities: Provides initial on-boarding for new team members and/or training for specific payer/payers Ability to identify Worklists in need of help and works those Worklists without the need of the Supervisor, Performance Manager or Manager. Reviews daily Accounts with No Activity #60 Days Report and under direction of the Performance Manger, works accounts. Communicates professionally, timely and effectively in English, both verbally and in writing. Provide support to Supervisor, Performance Manager, Manager and Director Credentials and Experience: High School Diploma required Minimum of Five (5) years recent medical collections experience in a hospital or large group practice setting. For a large group setting, primary responsibility is that of insurance collections and follow-up and/or Denials Management. Knowledge of Commercial / Managed Care contract payer reimbursement methodology, calculations/language and third party payer reimbursement policies #