Position Summary:
The Third Party Recovery Lead brings with them a long professional history of patient access, billing, account resolution, denial management, and collections experience. Oversees and is responsible for the activities of all junior level Recovery Specialists. Creates and reports team scorecards and is responsible for ensuring Team hits target metric goals. Responsible for accurate and timely filing of healthcare claims. Responsible for all actions required in resolving account balances. Candidate must have the ability to adjust to an uneven flow of incoming workload. Must be able to demonstrate excellent time management skills and be able to set timelines and goals to ensure that all assigned duties are accomplished within established time frames. Ability to coordinate reimbursement resolution with all payer types. In addition this individual has supervisory responsibilities for all junior level Recovery Specialists assigned to workforce team. This individual is the primary escalation point for all operational issues prior to the supervisor or manager.
Position Qualifications:
- Bachelor's Degree required. Degree requirement can be waived on a year for year basis for a combination of education and experience.
- Ten (10) years' experience in health care reimbursement. Five (5) years' customer service experience. Two (2) years' experience with Indian Health Services (IHS) tribal business office functions. Experience managing the collections, denials, and reimbursement of complex lines of business such as Long Term Care, Inpatient, Ambulatory Surgery, or Behavioral Health.
- AAHAM CRCS-I/-P required or must be obtained within one (1) year of employment. CPC Preferred. AMBA Medical Billing Certification Preferred. HFMA CRCR Preferred.
- CPC Preferred
- Experience using office machinery including printers, photocopiers, fax machines, and multi-line phone systems.
- Experience with Cerner Millennium Revenue Cycle preferred. IHS Tribal Billing knowledge preferred. College level course in Medical Terminology preferred. Versed in Microsoft Office Suite. Typing speed of 50 wpm, 10-key calculator skills, by touch. Ability to speak Yupik preferred. Must be able to demonstrate working knowledge of the CMS 1500 & 1450 claim forms. Teamwork is required. Must be able to work in conjunction with others in department to ensure that required common goals are met.
- Supervises Assigned Team members workload, productivity, attendance, KRONOS Time & Attendance, Team Scorecards, Reports, and Other Admin as assigned
Benefits Include:
- Generous PTO - beginning at 4.5 weeks
- Ten paid holidays
- Comprehensive healthcare coverage
- Life and Disability Insurance
- Flexible Spending Account
- Retirement plans
- Employee Wellness Center
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