Overview #This position performs the Billing, Collection and Reimbursement process for all Global Transplants. # Responsibilities Monitors policies and procedures to ensure accuracy and efficiency of the Transplant Billing # Collection process for the Medical Center. Identifies and reports missing, incorrect and incomplete data elements and claim submission requirements for the Transplant Billing and Collection process.
Ensures that the submission of transplant claims are completed within the established time frames.# Works closely with counterpart on physicians# billing side to identify and resolve issues to maximize reimbursement. Researches all credit balances, duplicate charges, outstanding contractual allowances, etc., and completes the appropriate refund, payment transfers, and/or charge corrections. Calculates appropriate distribution of payment received on Transplant claims through the use of the work RVU Global Distribution Model.
Attends and actively participates in Transplant meetings with Tufts-New England Medical Center Hospital Transplant Administrator. Processes all correspondence associated with Transplant billing and follow-up activities. Meets and exceeds departmental productivity and standards.
Performs other job related duties as required or requested. # Requirements Knowledge of managed care contracting preferred. Knowledge of PCs and proven ability to use spreadsheet software programs and word processing. Knowledge of Billing and accounts receivable software.# SMS/ Envision billing system experience preferred.
An understanding of CPT-4 and ICD-9 diagnosis coding. Excellent communication skills and the ability to communicate effectively with various levels within and outside of Tufts Medical Center. Ability to work independently in a fast-paced environment that can be highly stressful.
Bachelor#s degree or 2 years# experience in a healthcare billing office setting. Three years in a health care billing experience. An equivalent combination of education and experience which provides proficiency in the areas of responsibility listed above may be substituted for the above education and experience requirements.
Normal Office Environment. Must be able to perform all essential functions of this position with reasonable accommodation if disabled. The above statements are intended to describe the general nature and level of work being performed.# They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of personnel so classified.# Tufts Medical Center reserves the right to modify position duties at any time, to reflect process improvements and business necessity.
Lowell General Hospital