Delivery Lead Billing

Job Description

A Day in the Life Medtronic is expanding their footprint for Diabetes Care with a center in Pune and as a Delivery Lead Billing for Patient Financial Services, India, this role is responsible for ensuring the accuracy and completeness of billing and charges within the revenue cycle. This role involves reviewing, correcting, and processing billing errors, charge discrepancies, and claims denials within Patient Financial Services. The Diabetes Operating Unit focuses on improving the lives of those within the global diabetes community. As a business, we strive to empower people with diabetes to live life on their terms by delivering innovation that truly matters and providing support in the ways they need it. Our portfolio of innovative solutions is designed to provide customers greater freedom and better health, helping them achieve better glucose control, while spending less time managing their disease. This position is an exciting opportunity to work with Medtronics Diabetes business. Medtronic has announced its intention to separate the Diabetes division to promote future growth and innovation within the business and reallocate investments and resources across Medtronic, subject to applicable information and consultation requirements. This separation provides our team with a bold opportunity to unleash our potential, enabling us to operate with greater speed and agility. As a separate entity, we anticipate leveraging increased investments to drive meaningful innovation and enhance our impact on patient care. Responsibilities may include the following and other duties may be assigned: As a Delivery Lead Billing for Patient Financial Services, the role involves the specialist to work closely with various departments to ensure accurate coding, compliance with payer requirements, and maximization of reimbursement on Patient Financial Service accounts receivable metrics. Review and analyze charge capture data for accuracy and completeness. Identify and correct charge errors and discrepancies. Collaborate with clinical and coding staff to resolve charge-related issues. Monitor and review billing processes to ensure compliance with payer guidelines. Identify billing errors and make necessary corrections to avoid claim denials. Ensure timely and accurate submission of claims to payers. Manage the resolution of denied claims by identifying root causes and correcting errors. Resubmit corrected claims to payers for reimbursement. Track and report on claim correction activities and outcomes. Ensure all billing and charge correction activities comply with relevant laws, regulations, and internal policies. Stay updated on changes in billing regulations and payer requirements. Experience with various insurance plans offered by both government and commercial insurances (i.e., PPO, HMO, EPO, POS, Medicare, Medicaid, HRA s) and coordination of healthcare benefits, including requirements for referral, authorization, and pre-determination. Required Knowledge and Experience: Bachelor s degree in business or accounting major is preferred. 10+ years experience in healthcare insurance collections, accounts receivable management, billing and claims processing, and insurance payor contracts. Advanced knowledge of insurance contracting, payor regulations, insurance benefits, coordination of benefits, managed care, and healthcare compliance, rules, and regulations. Advanced experience with reading, and understanding medical policy information, and utilizing insurance benefit and coverage information to recovery denied claims. Advanced experience with various insurance plans offered by both government and commercial insurances. Experience with medical billing and collections terminology - CPT, HCPCS, ICD-10 and NDC coding, HIPAA guidelines and healthcare compliance. This position is eligible for a short-term incentive called the Medtronic Incentive Plan (MIP).