The Cardiac Management Solutions division of ZOLL Medical Corporation develops products to protect and manage cardiac patients, including the LifeVest® wearable cardioverter defibrillator (WCD), the ZOLL cardiac monitor, and associated technologies.
Heart disease is the leading cause of death for both men and women in the U.S. At ZOLL, your work will help to ensure cardiac patients get the life-saving therapy they need. To date, the LifeVest WCD has been worn by hundreds of thousands of patients and saved thousands of lives.
ZOLL has been Pittsburgh’s Manufacturer of the Year, one of Western PA’s Healthiest Employers, and even one of Pittsburgh’s Coolest Offices. But it’s our unique opportunity to impact people’s lives that makes ZOLL the ideal place to build your career.
Position Summary: Collects A/R and writes appeals in insurance decisions.
Essential Duties and Responsibilities:
- Medical Collections: Utilize A/R reports from SoftAid and identify accounts that are past timely payment. Make contact with insurance company, vendor and patient to learn status of payment.
- Appeals: Write appeals to insurance companies to overturn denied or short paid claims.
- Medical Billing: Re-bill claims that are lost by insurance company/vendor and provide substantiating documentation if necessary.
- Documentation: Obtain necessary documentation (updated medical order, clinical notes, patient agreement, etc.) and submit to insurance carrier to affect payment of claim.
- Patient/Physician/Sales Interaction: Contact patient, physician office, and territory manager to relay and/or obtain pertinent information and/or documents to effect collection of claims.
- Medicare Telephone Hearings and Administrative Law Judge (ALJ) Requests: May need to assist in maintenance of spreadsheet for hearings and ALJ requests; submit request along with supporting documentation to CMS; track requests; follow-up with CMS on requests that have not been scheduled; prepare files for hearings and ALJ meetings, and participate in those meetings.
- Perform other duties as assigned by Management
Supervisory Responsibilities: None.
Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Education and/or Experience:
- H.S. Diploma or equivalent required.
- Minimum 2-3 years experience in medical collections and understanding of HCFA-1500 claim forms and re-billing process.
- Experience working with all payer types to include Medicare, Medicaid, and third party commercial insurance companies
- Ability to handle multiple tasks simultaneously under strict deadlines.
Language Skills: Ability to read and comprehend simple instructions, short correspondence, and memos. Ability to write simple correspondence. Ability to effectively present information in one-on-one and small group situations to customers, clients, and other employees of the organization.
Mathematical Skills: Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percent and to draw and interpret bar graphs.
Reasoning Ability: Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations.
Computer Skills: To perform this job successfully, an individual should have knowledge of Internet Explorer and MS Office Suite.
- The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- While performing the duties of this Job, the employee is regularly required to sit; use hands to finger, handle, or feel and talk or hear. The employee must occasionally lift and/or move up to 10 pounds.
- The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- The noise level in the work environment is usually quiet.
ZOLL is an Equal Opportunity Employer – minorities/females/veterans/individuals with disabilities/sexual orientation/gender identity.
ZOLL now mandates COVID vaccinations subject to legal exemptions.
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