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- Miami Beach, FL
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Government Collector (Medicare)
Mount Sinai Medical Center Fla • Miami Beach, FL
Posted 27 days ago
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As Mount Sinai continues to grow, so does our legacy of caring.
Mount Sinai Medical Center is proud to be South Florida's hospital of choice for great medicine. With more than 3,000 employees, 500 volunteers, 670 beds, 26 operating suites and more than 650 physicians and 950 nurses, Mount Sinai is South Florida's largest private independent not-for-profit teaching hospital.
It takes the contribution of many individuals to make Mount Sinai Medical Center the world-class institution it is today. As a team, we have focused our efforts on assuring that our patients receive high quality medical care. We're looking for motivated professionals who seek the challenge and stimulation of working in an academic medical center with an international reputation.
We are looking for sharp, enthusiastic, professionals to become part of the energy and join our team in the Business Office where you will engage in our efforts to improve patient satisfaction, clinical outcomes, and operational efficiency.
Excel experience preferred. Use of various payer online claims tools is a plus.
1. Follows up on claims to Medicare/Medicaid on a daily basis as well work any corrections that are not accepted by Medicare/Medicaid by signing on the DDE and/or FMMIS.
2. Reviews and works any reports on Medicare/Medicaid on as needed basis.
3. Ensures proper adjustments are made by the STAR system on Medicare/Medicaid accounts and correct any discrepancies.
4. Refers re-bills of late charge or late charge credits as needed by the Government area to the Billing Staff.
5. Works daily or highlights for Specialty Collector Medicare/Medicaid rejections either from the Remittance Advice or correspondence.
6. Assists and works on all TPL Audits on a timely fashion.
7. Maintains a working knowledge of all Government Guidelines from the Centers for Medicare & Medicaid Services (CMS) using their websites.
8. Attends all corporate compliance programs and seminars or educational programs that maintain an awareness of laws and regulations affecting the department.
9. Ensures that Star system is well documented at all times after working each account.
10. As needed works closely with Medical Records Department in order to comply with Medicare/Medicaid's request for records.
11. Assists or works Medicare/Medicaid credit balances weekly and prepares the quarterly Medicare Credit Balance report or Medicaid overpayment worksheet for management review and approval.
12. Maintains a high level of productivity while maintaining accuracy on all assigned accounts which will insure accounts receivable objectives >60 days does not exceed 10% in government area.
13. Reports any obvious errors with HCPCS and ICD9 to Lead Collector/Biller or Manager.
14. Ensures all self -administered Drugs charges have been handled properly either by billing Medicaid, patient, or adjusted to 8101.
15. Acts as backup for handling med-pending I-plan removal from accounts once Medicaid benefit approval or denial is received.
16. Assists specialty collector on all payment differential between Medicare co-insurance and Medicaid payments applying T210 code as needed.
17. Assists or works Bad Debt reports on a monthly basis and assist in verifying any non-governmental insurance after patient discharge as needed prior of updating system.