Schedule: Full-Time Regular
Shift: Day shift
Associate's degree required
1-2 years experience is required
Reports to the Team Leader and Supervisor, Billing and Collection of Patient Accounts. Performs all billing, follow-up, rebilling and collections activities on third party inpatient and outpatient accounts to obtain final payment from the primary and secondary carriers. Recommends third party adjustments and write-offs to Team Leader or Supervisor.
Researches and performs billing and follow-up activity for all assigned financial classes using tape, paper and/or electronic media.
Performs secondary payor billing and follow-up activity in accordance with appropriate carrier specifications for all assigned accounts/financial classes.
Reviews, evaluates and processes all appeals through research and resubmission to appropriate third party of complete and accurate supporting documentation.
Researches and recommends third party appeal adjustments and/or write-offs to Team Leader.
Researches and recommends other third party adjustments and/or write-offs to Team Leader based upon collectability of account.
Contacts third party payors and guarantors to discuss and resolve payment issues and questions.
Minimum of two years experience in an automated medical billing and collection environment for a medical services provider and/or third party payor, preferably a large volume physician practice.
A high school diploma or equivalent required.
A comprehensive working knowledge of the application of Commercial, Workers Compensation and other third party payor rules, regulations, guidelines and requirements for billing, collection and reimbursement appeals. A basic understanding of how these regulations are applied to Massachusetts providers is desirable.
Ability to learn PC based computer systems, word processing, database and spreadsheet software programs.
Ability to use a typewriter, calculator, Blue Shield, Medicare and Medicaid and other third party computer/electronic application systems efficiently and effectively.
Completion of a medical terminology course and understanding of CPT and ICO diagnosis coding preferred.
Billing and accounts receivable software knowledge desired. lDX billing and/or paperless collection system experience preferred.
Tufts Medical Center is a world-class, academic medical institution in Boston, and is home to two full-service hospitals, one serving adults...