Credit – Collections Clerk II
Careers That Change Lives
In this exciting role as a Collections Clerk II you will have responsibility for following prescribed procedures and desk guidelines, performs a variety of insurance verification tasks relating to general healthcare guidelines. Verifies accuracy of statements (patient and payor related) as well as other healthcare financial accounting documentation or records. Enters data into computer systems using defined computer resources and programs. Compiles data and prepares a variety of reports. May reconcile records with GFS team members and leaders; communicates with external vendors and customers (including representatives of health plans/payors.)
Executes on established departmental objectives and assignments which affect the immediate operation, but that also have full revenue cycle and ultimately company-wide financial impact.
The Diabetes Group is working with the global community to change the way people manage diabetes. Together, we will transform diabetes care by expanding access, integrating care, and improving outcomes; so people with diabetes can enjoy greater freedom and better health.
A Day in the Life
- As a key member of the Global Financial Services (GFS) customer care team, responsible for all aspects of Insurance verifications and authorization activities, including customer service with an objective of maximizing cash flow and keeping denials to a minimum.
- Initiates follow-up activities regarding open authorizations, makes written and verbal inquiries to payors. Analyzes and problem solves account issues to full resolution.
- Provides support for inquiries from internal and external customers regarding account/authorization status. Maintains updated information on patient accounts.
- Handles internal and external customer inquiries regarding authorization status and insurance verification history.
- Performs eligibility verifications on patient accounts as new insurance plans/carriers are identified; updates information on expired insurance plans/carriers.
- Researches issues off-line as needed with payor/physicians/ patient; conducts follow-up calls with customers, initiating conference calls between insurance carrier and patients to resolve customer concerns.
- Meets or exceeds key performance indicators measuring productivity, quality, and service level as defined by Senior Management.
- Additional team activities, projects, and work flow as assigned.
Must Have: Minimum Requirements
To be considered for this role, please ensure the minimum requirements are evident on your resume.
- High School Diploma or GED
- 2+ years insurance authorization (including benefits, eligibility, and verification), billing and/or collections experience in a medical group, health care company, or hospital setting.
- Experience with medical billing and collections terminology (e.g. CPT, HCPCS, and ICD-9, ICD-10 coding)
Nice to Have
- Experience in handling high volume medical authorization and insurance verification inbound and outbound calls, providing world class customer service.
- Experience with various insurance plans offered by both government and commercial insurances (PPO, HMO, EPO, POS, Medicare, Medicaid, HRAs, etc.) and coordination of healthcare benefits, including requirements for referral, authorization, and pre-determination.
- Experience with reading and understanding the information provided on EOBs, remittance advices, and other insurance correspondence and/or in calculating patient responsibility taking into consideration coverage and benefits, including referral, authorization, and/or pre-determination requirements, and contract terms
- Experience with HIPAA guidelines and healthcare compliance.
- Experience with MS Office suite (Word, Excel, Outlook), and internet and web site navigation.
- Strong customer service skills with ability to interact with both internal and external customers, i.e. patients, insurance payors, physicians, internal departments and handle in a professional manner with customer-friendly focus and attention to detail in resolving issues.
- Experience with Advanced MD
- Proficiency in navigating multiple screens and programs at the same time to facilitate problem solving, and other activities that require multi-tasking.
- Ability to maintain composure, and to follow instructions and protocols when dealing with unfamiliar or unusual payor / customer issues.
- Strong collaboration skills (including active listening skills, presentation skills) and experience working effectively in a diverse, inclusive organization and environment.
- Experience prioritizing work, handling daily and multiple tasks to completion within the time allotted, while working as part of a team within a demanding environment.
- Experience in a large corporate environment
Together, we can change healthcare worldwide. At Medtronic, we push the limits of what technology, therapies and services can do to help alleviate pain, restore health and extend life. We challenge ourselves and each other to make tomorrow better than yesterday. It is what makes this an exciting and rewarding place to be.
We want to accelerate and advance our ability to create meaningful innovations – but we will only succeed with the right people on our team. Let’s work together to address universal healthcare needs and improve patients’ lives. Help us shape the future.
Physical Job Requirements
The above statements are intended to describe the general nature and level of work being performed by employees assigned to this position, but they are not an exhaustive list of all the required responsibilities and skills of this position.
The physical demands described within the Day in the Life section of this job description are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.