Underpayment Appeals Collector

Mednax - Raleigh, NC2.9

MEDNAX has grown from a single medical practice to a trusted Health Solutions Partner with more than 10,000 employees and a presence in 50 states. Through our family of companies, we provide:

physician services spanning the continuum of patient care
revenue cycle management solutions
performance improvement consulting
We invite you to grow with us and help shape the future of health care.

The Underpayment Appeals Collector assists with managed care contracts and governmental payment compliance and ensures third party payer compliance with negotiated contracts. The incumbent also serves as a liaison between third party payers, staff, management, and clients related to third party disputed payment activities.

Responsibilities include: review of accounts, identifying underpayments and posting appropriate transaction code for follow up. The collection efforts on outstanding accounts includes: telephone contact with payers, working daily & monthly underpayment reports, auditing accounts and submitting appropriate correspondence for follow-up. Individual will perform required tasks on applicable software systems as well as MS Excel and Word.

Candidates with prior Medical Collections experience who possess current knowledge of Managed Care contracts and governmental payment obligations are strongly encourgaed to apply for consideration.

  • Educates staff regarding disputed third party payer contract guidelines as needed.
  • Coordinates meetings between third party payers and staff for educational purposes as well as issue resolution.
  • Reviews monthly internal reports for third party payer contract compliance issues.
  • Develops and maintains superior relationships with third party payer representatives. Builds strong relationships and demonstrates professionalism with customers, coworkers, management, and vendors.
  • Adheres to all applicable laws, regulations, policies and procedures governing PHI and all matters pertaining to confidentiality.
  • Produces top-quality work handling a wide range of administrative functions.
  • Demonstrates initiative with attention to detail and follow-through.
  • Gathers and analyzes claims payment data to determine and resolve third party payer compliance with negotiated contracts.
  • Communicates verbally and in writing with third party payers and payer representatives as to contracting initiatives in addition to communicating in writing with third party payers, staff, management and clients to keep informed of and resolve third party payer compliance issues.
  • Builds and manipulates Excel spreadsheets with ease.
  • Continuously pursues professional development and education activities to maintain and improve current knowledge of the field.
  • Assists in evaluation of reports, decisions, and results of department in relation to established goals.
  • Actively participates in problem identification and resolution and coordinates resolutions between appropriate parties. Recommends new approaches, policies, and procedures to influence continuous improvements in department’s efficiency and services performed.
  • Takes ownership of special projects, researches data and follows through with detailed action plans. Coordinates and completes multiple projects in a deadline and production-oriented environment.
  • Adheres to Departmental, Corporate and HR policies and procedures.
  • Performs other duties as assigned or requested.
Associate's degree (A. A.) or equivalent from two-year college or technical school; or one to two years related experience and/or training; or equivalent combination of education and experience.
Proficiency with MS Word and Excel is required.
Ability to read, analyze and interpret: general business periodicals, a variety of instructions, technical procedures or government regulations furnished in written, oral,form.
Ability to write reports & business correspondence.
Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public
This position requires the flexibility / ability to adapt to rapidly changing business organizational needs.
Strong customer service orientation and excellent written/verbal communication skills are necessary.
Must demonstrate strong problem-solving capabilities
Must possess current knowledge of Managed Care contracts and governmental payment obligations.
Prior Medical Collections experience is required.

MEDNAX IS AN Equal Opportunity Employer

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status