Job description

Collector, Resolution & Denial
As Mount Sinai grows, so does our legacy of caring

Located in the heart of Miami Beach, overlooking the breathtaking intracoastal waterway, Mount Sinai Medical Center is dedicated to providing exceptional health care to our diverse community enhanced through innovation, technology, teaching, and research.

Mount Sinai is South Florida's largest private independent not-for-profit hospital with 672 beds, and a tight-knit community of more than 4,000 employees.

We provide world-class care:

• Named one of America's 250 Best Hospitals for 2020 and 2021 by Healthgrades, positioning Mount Sinai among the top 5% of hospitals in the nation for overall clinical excellence.
• A pioneer in innovative medical research in areas such as cardiology, cancer, memory disorders and pulmonary diseases
• The BEST cardiac surgery survival rate in Florida
• A new seven-story Surgical Tower with 154 all-private rooms and patient centered technology promotes an exceptional patient experience

Position Responsibilities:

• Assist Lead with all related functions to insure cash goals are met daily.
• Work on payer projects as requested and report any pattern identified with payer reimbursement to lead.
• Report any incorrect charges or not captured any errors with HCPCS and ICD9s to the appropriate department and notify lead.
• Review denied/rejected claims and re-bill as needed on a daily basis. Re-ensure that corrections requested are re-billed and sent to insurance carrier.
• Attend all corporate compliance programs and seminars or educational programs that maintain an awareness of laws and regulations affecting the department and facility.
• Maintain all accounts well documented at all times. Proper documentation includes but is not limited to the name of the person you talked to what issue was discussed phone number called what is the outcome of the call and/or who was the issue forwarded to.
• Review denials and underpayments by utilizing HBOC collector workstation and bad debt report to achieve and maintain a high level of productivity of 40 accounts on a daily basis.
• Contact Insurance companies on claims resolutions daily and ensure that claims are followed up in accordance to denial unit policies and procedures.
• Adhere to Hospital Guidelines departmental policies and procedure on a daily basis.
• Ensure that assigned accounts are adjusted properly that expected reimbursements are documented and report any incorrect calculations to the Managed Care department and notify lead.
• Review and work denial letters scanned in HPF system on a daily basis in accordance to denial unit policies and procedures.
• Assist other departments as needed.
• Ensure that proper supporting documentation is sent with appeals.
• Provide all information requested by insurance in a timely manner as well as appeal all denied claims within re-filing limit.

Qualifications:

• One year working with HMO contracts and HCFA Guidelines Hospital experience preferred.
• High School Graduate

Benefits:

We believe in the physical and mental well-being of our employees and are committed to offering comprehensive benefits that fit their personal needs. Our robust employee benefits package includes:

• Health benefits
• Life insurance
• Long-term disability coverage
• Healthcare spending accounts
• Retirement plan
• Paid time off
• Tuition reimbursement
• Employee assistance program
• Wellness program
• On-site childcare & Mater School grades K-3
• On-site housing for selected positions and more!

Job Type: Full-time

Pay: $15.00 - $18.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Disability insurance
• Employee assistance program
• Health insurance
• Life insurance
• Paid time off
• Referral program
• Tuition reimbursement
• Vision insurance
• Work from home

Schedule:

• Day shift
• Monday to Friday

Supplemental pay types:

• Monthly bonus

Ability to commute/relocate:

• Miami Beach, FL 33140: Reliably commute or planning to relocate before starting work (Required)

Work Location: One location

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