DaVita Medical Collector- St. Petersburg FL in ST. PETERSBURG, Florida

Medical Collector- St. Petersburg FL

Description

DaVita Medical Group manages and operates medical groups and affiliated physician networks in California, Nevada, New Mexico, Florida, Colorado and Washington in its pursuit to deliver excellent-quality health care in a dignified and compassionate manner. As of June 30, 2016 DaVita Medical Group (formerly HealthCare Partners) provided integrated care management for approximately 760,000 patients. DaVita Medical Group’s leadership development initiatives and social responsibility efforts have been recognized by Fortune, Modern Healthcare, Newsweek and WorldBlu.

We are committed to bringing the benefits of coordinated care to our patients and to taking a leading role in the transformation of the national healthcare delivery system to assure quality, access, and affordable care for all.

If you're looking to make a difference with a large, financially stable, well-recognized medical group, DaVita Medical Group may be the employer for you.

We are seeking aCollector III to join our talented team!

Overview:

Responsible for performing complex or specialized collection functions by interfacing with various departments, insurance carriers, and patients while ensuring good relations.

Essential Functions:

  • Employee will consistently exhibit behavior and communication skills that demonstrate JSA/Healthcare Partners’ (HCP) commitment to superior customer service, including quality, care and concern with each and every internal and external customer.

  • Identify payment and denial trends and communicate to Supervisor of Collections.

  • Provides timely resolution to incoming calls to Billing and Collections.

  • Documents all calls clearly and precisely at time of call.

  • Performs necessary follow-up to ensure timely resolution of appeals, rebilling’s, obtaining updated insurance information, identifying and correcting billing errors, etc.

  • Meets department productivity standards.

  • Maintains current working knowledge of CPT and ICD-9 codes, required modifiers and encounter data.

  • Maintains up-to-date information on Medicare laws, HCFA requirements, contractual arrangements and other third party payer requirements.

  • Responsible for review and assignment of payer fatal edits from clearinghouse and documenting edits and resolution for audit.

  • Apply knowledge of third party payer guidelines in reviewing denied claims to ensure appropriate use of modifiers and CPT/ICD-9 codes.

  • Communicate system, credentialing and claim formatting issues to the Supervisor, Collections.

  • Performs collection activities on assigned work files according to department procedures.

  • Employee will use, protect and disclose JSA/HCP patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.

  • Employee will perform additional duties as assigned.

  • Other duties as assigned.

Qualifications

Education:

  • CPC CCS-P, or CPMA certification required.

  • High School diploma or equivalent

Experience:

  • Must have 2-3 years of coding experience in a Primary Care environment.

Knowledge, Skills, and Abilities:

  • Excellent understanding of medical terminology, disease process and anatomy and physiology.

  • Strong understanding of ICD-9-CM coding classification.

  • Excellent understanding of CPT coding within a Primary Care environment.

  • Knowledge of Risk Adjustment and Hierarchical Condition Categories (HCC) and Medicare Advantage reimbursement a plus.

  • Strong Computer skills (i.e. MS Office).

  • Good organizational skills and ability to meet designated deadlines and productivity standards

  • Ability to work well with all levels of staff in a courteous, professional manner.

  • Strong interpersonal and communication skills.

  • Valid driver’s license

  • Ability to travel to various clinics within Florida.

  • Bilingual a plus (English/Spanish)

Primary Location FL-ST. PETERSBURG - 33702

Req ID: 301612