Third Party Collection Specialist
Tufts Medical Center - Boston, MA

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Department::Physicians Organization

Schedule: Full-Time Regular
Shift: Day shift
Grade: 6
Hours: 8-430p

Job Details:
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.

Responsibiltiies:
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.

Requirements:
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.

About this company
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Tufts Medical Center is a world-class, academic medical institution in Boston, and is home to two full-service hospitals, one serving adults...