MANAGED CARE ACCOUNT SPECIALIST III

Tenet Healthcare Corporation, through its subsidiaries, owns and operates acute care hospitals and numerous related health care services. Tenet's name reflects its core business philosophy: the importance of shared values among partners in providing a full spectrum of health care. Tenet's mission is to be recognized for the passion of our people and partners who provide quality, innovative care to the patients we serve in our communities. Our focus is on leadership, growth and philanthropy. It's a spirit you can experience first-hand and it's a philosophy that can enhance your own approach to health care, and your career goals. From the resources that go with being one of the largest investor-owned health care providers in the U.S., to our multiple locations coast to coast, one thing is clear - Tenet offers significant employment opportunities. So whatever you need to grow as a professional, we'll do our best to provide. All you need to bring is yourself ! Tenet is currently seeking a MANAGED CARE Account Specialist III for its Anaheim Business Office. The Account Specialist III is responsible for the following: Responsible for maximum productivity in the recovery of delinquent accounts receivable. Documents all collection activity; maintains and organizes unit and responds to all correspondence, communication and/or verbal inquiries from all relevant parties. Reviews explanation of benefits (EOB) and or contracts to verify responsible parties Prepares unrecoverable accounts for assignment to legal counsel. Prepares for appeals and revised billing as required. Provides coaching and training to lower level staff. Records and maintains complete and accurate documentation of all activity performed on appropriate medium.Qualifications: High School Diploma or equivalent Working knowledge of UB04, EOB and contract interpretation. Understanding of Managed Care plans and collections. 5-7 years experience in a medical insurance collections or Worker’s Compensation collections environment Proven experience in managing account follow-up Advanced data entry and other computer skills Decision-making ability; ability to work with minimal supervision Effective organizational skills; flexibility in working multiple issues Excellent customer service, interpersonal, analytical and math skills Ability to work in a fast paced environment and adapt to changes quickly Intermediate knowledge of Microsoft products (Word, Excel, Outlook) and typing skills required Advanced knowledge of UB-92 and EOB interpretation (Medicare, Medicaid, Managed Care, Supplemental Plans) Ability to adhere to HIPPA regulations Advanced  knowledge of CPT and ICD-9 codes Bilingual skills preferred Tenet offers a competitive compensation and benefits package that includes Free medical HMO, Paid Time Off, 401(k) match, tuition reimbursement, health club reimbursement, scholarship programs, discounted cell phone service, and more. EOE