Employment Type: Full-Time
National health solutions partner comprised of the nation's leading providers of physician services.
With MEDNAX, you are choosing more than just a job. You are establishing your career path with one of the nation's top health care leaders, committed to take great care of the patient, every day and in every way.
The Team Leader is responsible for effective and efficient accounts receivable management of assigned payers. The collections efforts on outstanding accounts includes; telephone contact with payers and parents, work collection reports and correspondence, audit accounts, appeal denied claims as necessary, update accounts as necessary, identify carrier related denial trends and meet departmental productivity standards.
In addition, the Team Leader is to assist the Manager in maintaining goals set for the department and associates. The goals include; run or request Accounts Receivable reports as needed, review adjustments and refunds prior to the manager receiving as required, monitor problem packs and appeals, and perform supervisory tasks as needed. Responsible for the daily auditing of the department's Collectors' work to ensure accounts are taken to the next level.
Performs required tasks on GPMS, electronic claims vendors' software, Medifax, MS Excel and Word.
* Assists with Managerial tasks within the respective department.
* Review and audits Associates' productivity. Identifies Associates' areas of additional training.
* Assist with Associates' difficult accounts and workload.
* Continually provides training to the Associates.
* Monitors Associates' hours worked.
* Provides backup support in Manager's absence.
* Works closely with the Manager on a daily basis to ensure a smooth operation within the department.
* Make necessary telephone or written contact.
* Contact payers to check claim status and reimbursement.
* Contact parents to obtain accurate insurance information.
* Phone appeals on denied claims.
* Contact payer regarding carrier issues.
* Provide Call Center backup as needed.
* Send appropriate letters.
* Consistent follow-up on outstanding accounts by running and working collection reports and correspondence.
* Not Worked Report - Summarizes outstanding accounts not worked within the department's guidelines.
* 1499 Report - Identifies registered Commercial accounts that have been paid as Managed Care.
* Denial Report - Identifies specific denials posted from EOB's received.
* Residual Report - Identifies balances remaining after payer has made a payment.
* Queue Summary Report - Identifies the accounts that are scheduled to be worked for a given day.
* Clearinghouse Reports - Identifies specific denials for claims submitted electronically.
* Review, distribute and/or work all daily correspondence received from patients and payers.
* Perform audits on accounts when needed.
* Review accounts for accuracy (ie; payments have been posted correctly, appropriate adjustments have been made, etc.).
* Process and/or review refunds for overpayments made by payers and patients.
* Process and/or review adjustments as necessary (ie; contractual, good faith, settlement, etc.).
* Appeal denied claims via mail or telephone.
* Request Accounts Receivable Status Reports when a denial trend has been identified.
* Review accounts receivable report detail for denial trends.
* Obtain Medical Records from Hospital Associates and send them to the payer.
* Review diagnosis and procedure codes with the Coding Department.
* Submit and/or monitor problem packs or appeals to payers.
* Update accounts as necessary.
* Update accounts in GPMS with information obtained through correspondence and telephone (ie; insurance, authorization, address, baby's name, etc.).
* Completes appropriate account maintenance by ensuring that the correct statement groups, financial class, and payer codes are current and timely.
* Identify carrier related denial trends.
* Review denial reports (GPMS Denial, electronic claims, Not Worked) for payer trends.
* Elevate problems to department Manager.
* Meet or exceed required departmental productivity standards on a consistent basis.
Associate's degree (A.A.) or equivalent from two-year College or technical school; or one to two years related experience and/or training; or equivalent of education and experience.
The above noted job description is not intended to describe, in detail, the multitude of tasks that may be assigned but rather to give the associate a general sense of the responsibilities and expectations of his/her position. As the nature of business demands change so, too, may the essential functions of this position.
MEDNAX IS AN Equal Opportunity Employer
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status