Assist team by accepting and resolving escalated patient calls. Interact with various sources, including CSC, carrier, and provider when patient responsibility is challenged. Attend meetings with upper management to discuss policy and procedural changes/updates in all areas of CareCentrix. Guides team towards the successful collection of invoice processing activities to ensure receivables are reimbursed on an accurate and timely basis. Handle high profile accounts, and respond to up line entities, including but not limited to, upper management, attorney general, Better Business Bureau, CSC, carriers, and providers. Support upper management in making data driven decisions with accurately run reports, and data analysis. Identify and escalate patient issues and concerns to the appropriate supervisor. Act as back up to supervisor in their absence. Work under minimal supervision.
Lead Patient Account Specialist
High School Diploma or the equivalent plus a minimum of 4-5 years medical claims and reimbursement processing experience generally required. Knowledge of healthcare collection procedures and a variety of system applications, both internal and external is required. Knowledge of Utilization Management and URAC standards. Effective analytical, verbal, written communication, mathematical calculations, and professional judgment skills are required. Knowledge of HIPPA guidelines and the Fair Credit and Collections Act is desired but not required. HCPC, CPT and ICD-9 coding is also desirable advanced competency of Microsoft Office Applications and mathematical calculations. Guidelines exist with some decisions requiring discretion in their application. Strong project management skills desired.
CareCentrix maintains a drug-free workplace in accordance with Florida’s Drug Free Workplace Law.