At Medtronic you can begin a life-long career of exploration and innovation, while helping champion healthcare access and equity for all. You’ll lead with purpose, breaking down barriers to innovation in a more connected, compassionate world.
Responsibilities may include the following and other duties may be assigned:
As a Credit Collections SME for Patient Financial Services, the role involves performing a variety of tasks using standard healthcare guidelines. Main objective is followed up collection activities including rebilling, appeals and recovery activities for denied or short paid claim
Executes on established departmental objectives and assignments which affect the immediate operation, but that also have full revenue cycle and company-wide fiscal impact.
Initiates follow-up activities with third-party payors regarding open claim balances; makes written and verbal inquiries to payors.
Analyzes and problem solve account issues to full resolution.
Manages internal and external customer/business inquiries regarding account status and account history.
Research issues off-line as needed with payor/patient; conducts follow-up calls with payors and customers, initiating conference calls between insurance carrier and patients to resolve customer concerns.
Research and initiates refund requests due to overpayments by payor and/or patient.
Determines when claims/accounts are deemed uncollectable; recommends and initiates bad debt write-offs procedures.
May reconcile records with PFS team members and leaders; communicates with external vendors and customers (including representatives of health plans/payors.)
Required Knowledge and Experience:
Bachelor’s degree on business or Accounting major is preferred.
4 to 6 years of Insurance Collections experience in a US healthcare environment.
Demonstrated ability to prioritize work, managing daily and multiple tasks to completion within the time allotted.
Ability to prepare forms, spreadsheets, and graphs.
Experience in a payor or medical provider community that deals with all aspects of the revenue cycle.
Experience with reviewing and analyzing insurance payments, and/or payer adjudication claims against contract terms and patient coverage and benefits.
Experience reading and understanding the information provided on EOBs, remittance advices, and other insurance correspondence, and in calculating patient responsibility taking into consideration coverage and benefits, including referral, authorization, and/or pre-determination requirements, and contract terms.
Experience with various insurance plans offered by both government and commercial insurances (i.e., PPO, HMO, EPO, POS, Medicare, Medicaid, HRA’s) and coordination of healthcare benefits, including requirements for referral, authorization, and pre-determination.
Experience with medical billing and collections terminology – CPT, HCPCS and ICD-10 coding.
Experience with HIPAA guidelines and healthcare compliance.
Previous experience in receiving and making outbound calls to patients to explain insurance benefits related to health insurance, and/or discussing patient financial responsibilities.
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.
Medtronic offers a competitive Salary and flexible Benefits Package
A commitment to our employees lives at the core of our values. We recognize their contributions. They share in the success they help to create.We offer a wide range of benefits, resources, and competitive compensation plans designed to support you at every career and life stage.
We lead global healthcare technology and boldly attack the most challenging health problems facing humanity by searching out and finding solutions.
Our Mission — to alleviate pain, restore health, and extend life — unites a global team of 90,000+ passionate people.
We are engineers at heart— putting ambitious ideas to work to generate real solutions for real people. From the R&D lab, to the factory floor, to the conference room, every one of us experiments, creates, builds, improves and solves. We have the talent, diverse perspectives, and guts to engineer the extraordinary.
Learn more about our business, mission, and our commitment to diversity here