The position is in support of the Uniform Business Office at Walter Reed National Military Medical Center (WRNMMC). WIll perfom 'Third party collection' services for the medical center and process medical accounts receivables.
* Process Medical Accounts Receivables by maintaining ledgers, compiling, consolidating, checking and arranging funding data. * Generate and submit medical claims to insurance companies ensuring all set rules, regulations, and/or procedures are adhered to. * Strategies, policies and procedures will be developed for Government review and approval. * Train contractor staff members upon government request on accounting, budgeting, third party collections or other financial programs required. * Maintain account receivable records, claims, billing receipts and history files. * Develop and maintain tickler files for tracking delinquent accounts receivables. * Track and process all overdue Medical Accounts Receivables. * Prepare letters to organizations to request payment on delinquent Medical Accounts Receivables * Develop a process to track and maintain a file of these letters and the result collections. * Provide guidance to internal and external contacts and insurers regarding questions concerning patient medical claims. * Act as point of contact between private insurance companies regarding Accounts Receivables actions. * Research, extract and summarize reimbursable information, submitting all reports to the government. * Post, examine, balance, and extract data from records to prepare reports.
* Associates Degree or Five (5) -Seven (7) yrs experience in a similar field or scope of work * Basic knowledge of accounting systems, policies and procedures * Basic Knowledge of medical terminology * Possess a public trust or active secret clearance
* Skill to communicate orally and in writing to collaborate with the third party insurers in obtaining * Pre-certification, avoid assessment of penalties, and reach agreement on insurance coverage parameters * Ability to use automated systems effectively * Familiarity with a variety of the medical field's concepts, practices and procedures. * The Contractor must have ability to work accurately with figures. * Knowledge of or the ability to learn and function within, the medical systems in use at the site (CHCS, ADS, ARMS PRO, etc.). * Knowledge of insurance plans and their terminology (example: HMO's vs TPA and PPO plans). * Knowledge of or the ability to learn and adhere to, DoD instructions, DHA regulations, and policies regarding Third Party Collections. * Familiarity with NDC, CPT, and ICD-9/ICD-10 codes and applicable coding guidelines. * Thorough familiarity with health insurance industry practices regarding claims processing and EOB content