Team Leader - Government Collections

Hybrid work schedule - Base salary plus bonus

As Mount Sinai grows, so does our legacy in high-quality health care.

Since 1949, Mount Sinai Medical Center has remained committed to providing access to its diverse community. In delivering an unmatched level of clinical expertise, our medical center is committed to recruiting and training top healthcare workers from across the country. We offer the latest in advanced medicine, technology, and comfort in 12 facilities across Miami-Dade (including our 674-bed main campus facility) and Monroe Counties, with 38 medical services, including cancer care, 24/7 emergency care, orthopedics, cardiovascular care, and more. Mount Sinai takes pride in being South Florida's largest private independent not-for-profit hospital,dedicated to continuing the training of the next generation of medical pioneers.

Culture of Caring: The Sinai Way

Our hardworking, tight-knit community of more than 4,000 dedicated employees fosters an environment of care and compassion. Each member plays a vital role in our collective mission to deliver excellent healthcare through innovation, education, and research. At Mount Sinai, we take pride in our achievements, aiming to be a beacon of quality healthcare in South Florida. We welcome all healthcare professionals to join our thriving community and contribute to our pursuit for clinical excellence.

Responsibilities: 

Assist Manager with all government collection related functions to ensure cash goals are met monthly/yearly.         Maintains a high level of productivity and accuracy; ensures Medicare accounts receivable objectives >60 days does not exceed 10% and Medicaid > 90 days does not exceed 15%. Assists, reviews and corrects Medicare return claims list daily by signing on to Direct Data Entry (DDE), Common Working File (CWF), Return to Provider (RTP) and Additional Development Returns (ADR).            Assists in completing weekly Medicare/Medicaid Credit balances and acts as back up in preparing the quarterly Medicare Credit Balance report and/or Medicaid Overpayment worksheet.          Works, resolves and documents all Third Party Liability (TPL)  Audits on a as needed basis which includes and is not limited to Medicaid or Medicare.               Oversees and ensures that all Medicare and Medicaid remits are completed and adjusted properly on a daily basis; works closely with Manager to eliminate repetitious system errors.                       Reviews and works Receivable Workstation (RWS) plus any reports on Medicare/Medicaid accounts on a daily basis, or as assigned by Manager.                                           Researches and reports all errors with HCPCS and ICD9 to the Manager on an on-going basis and works closely with department involved for resolution.                                      Assists staff with Medical Records request issues to comply with Medicare/Medicaid time guidelines.       Reviews and works balance aging reports for Medicare/Medicaid accounts as needed.         Reports to Manager the claims discrepancies where Medicare or Medicaid has to be notified for claim resolution.                  Attends all corporate compliance programs, seminars or educational programs that maintain an awareness of laws and regulation affecting the organization.                    Maintains a working knowledge of all Government Guidelines from the Centers for Medicare & Medicaid Services (CMS) using there websites.                  Acts as a daily liaison between collections and billing.  Verifies any non-governmental insurance after patient discharge as needed prior of updating system. Coordinates and handles agency requests and special projects.                                Overseas Bad Debt processes; acts as back-up when needed.                                  

Minimum Requirements:

High School Diploma One year working with medicare/medicaid Billing/Collections and HCFA Guidelines Hospital Experience preferred

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 Pet Insurance Tuition reimbursement Employee assistance program Wellness program Share