What are the responsibilities and job description for the Third Party Recovery Lead position at University Medical Center of El Paso?
Job Summary
Under the direction of the Accounting Supervisor, leads Associates and is responsible for all pertinent functions related to coordination of benefits, provider refunds, and subrogation recoveries. Serves as the subject matter expert in third-party recovery and all related areas. Provides support and guidance in the responsibilities for contacting insurance carriers, providers, and other intermediaries to obtain information on other insurance coverage for El Paso Health or Preferred Administrators members. Ensures that detailed documentation is obtained to assist in subrogation recoveries whenever needed. Oversees the preparation of specific State mandated monthly and quarterly reporting, as it pertains to Third-Party Recovery (TPR) processes. Serves as the liaison between Third-Party Recovery and Finance. Works closely with Finance by providing support in key areas such as performing claims check processing for specific product lines during the absence of the Accountant I, and assisting/cross-training with other Finance related duties as indicated in Essential Duties/Responsibilities.
Skills
1. Knowledge of QNXT, computer software programs and basic office equipment.
2. Knowledge of Medicare, Medicaid and all other third-party billing requirements.
3. Effective written and verbal communication skills.
4. Analytical and problem-solving skills required.
5. Ten-key by touch required.
6. Must have the ability to accurately enter data, describing appropriate follow-up activity.
7. Bilingual (English/Spanish) preferred.
Work Experience
Five years of healthcare/managed care experience in a business office collections setting is required. Strong understanding of health insurance, provider contracts, and basic coordination of benefit and subrogation process is required. Knowledge of medical terminology and CPT coding is preferred.
License/Registration/Certification
None.
Education and Training
High school diploma or equivalent is required. Associate degree is preferred.
