Insurance Data Management, Specialist III at Abbott Laboratories

Job Title

Insurance Data Management, Specialist III

Working at Abbott

At Abbott, you can do work that matters, grow, and learn, care for yourself and your family, be your true self, and live a full life. You’ll also have access to:

• Career development with an international company where you can grow the career you dream of.
• Free medical coverage for employees* via the Health Investment Plan (HIP) PPO
• An excellent retirement savings plan with a high employer contribution
• Tuition reimbursement, the Freedom 2 Save student debt program, and FreeU education benefit - an affordable and convenient path to getting a bachelor’s degree.
• A company recognized as a great place to work in dozens of countries worldwide and named one of the most admired companies in the world by Fortune.
• A company that is recognized as one of the best big companies to work for as well as the best place to work for diversity, working mothers, female executives, and scientists.

The Opportunity  

This position works onsite at our Livermore, CA location in the Abbott Heart Failure, Acelis Connected Health business.  Our Heart Failure solutions are helping address some of the world’s greatest healthcare challenges. 

As the Medical Collector, you’ll have the chance to:

• Serve as the liaison between insurance companies, patients and the departments; 

• Ensure claims are processed and followed up to meet company goals of account receivable days, aging account percentages and cash goals; 

• Research and answer all questions and complaints, regarding patient responsibility balances and billing inquiries sent to them through the customer call center with the highest degree of courtesy and professionalism.  

What You’ll Work On

The following reflects management’s definition of essential functions for this job but does not restrict the tasks that may be assigned. Management may assign or reassign duties and responsibilities to this job at any time due to reasonable accommodation or other reasons. 

Collector Level III   

• Research and resolve payment discrepancies.  

• Review and manage the AR aging report and provide explanations of past due balances to management. 

• Work aged accounts on assigned payers prioritizing accounts that are approaching timely filing denial. 

• Identify issues or trends with accounts and provide suggestions for resolutions. 

• Escalate exhausted appeals efforts for resolution with payer.  

• Performs assigned Revenue Cycle duties as directed by the Revenue Cycle Supervisor. 

• Able to submit a root cause analysis report. 

• Prepare write off requests as needed for any uncollectable balances. 

• Keeps supervisor informed of areas of concern and problems identified.  

• Provide training to new and existing staff members as instructed by supervisor. Use and follow company procedures in training. Quality check work to ensure accuracy, efficiency and uniformity. Re-train staff as often as needed. 

• Ensure staff complete all assigned tasks in a timely manner and that they have the resources and tools to perform their jobs. i.e. access to software. Advise supervisor immediately if they do not. 

• Review/knowledge of contracts to determine correct reimbursement for each account. 

• Analyze and document A/R problems and implement processes to enhance efficiencies. 

• Documenting accurate and appropriate notes on corresponding systems as needed. 

• Outgoing correspondence (internal or external) must be written in a clear, concise, and professional manner. 

• Provide coverage as needed to include performing staff’s work during their absences as assigned by management. Assist in areas of needs as assigned by supervisor. 

• Maintains positive and regular results-oriented communication with payer representatives. 

• Navigate and works all payer websites. Provide support to staff as needed. 

• Enroll in payer newsletters and advise manager of needs. 

• Initiate appeals to payers following the guidelines outlined for that payer. Note account and track appeal to resolution. 

• Utilizes strong communication and customer service skills.  

• Consistently practices good judgment and problem-solving skills when handling confidential information. 

• Regular attendance and punctuality.  

Key Results: 

• Working Denials in a timely manner that results in cash collection goals. 

• Represent company and team in a professional and positive manner. 

• Meet and exceed daily and monthly productivity goals. 

• Detailed oriented, careful and with a focus on quality in accomplishing tasks. 

• Able to toggle between computer screens 

• Issues identified and resolved within an average of 48 hours.  

• Adapts to changing business needs, conditions, and work responsibilities. 

• Effective communications with staff and management.  

• Always maintain confidentiality. 

• Present ideas for improvements and strategies to meet goals. Offer viable solutions to problems. 

• Promote teamwork, remaining available to assist staff as needed. 

• Performs any other function as required by management.  

• Report to manager any non-compliance with staff as observed by you. 

• Participate in personal development training and cross training as instructed by management. 

Required Qualifications  

• High school diploma or GED required 
• Excellent verbal and written communication skills, including ability to effectively communicate with internal and external customers. 
• Excellent computer proficiency (MS Office – Word, Excel and Outlook) 
• Must be able to work under pressure and meet deadlines, while maintaining a positive attitude and providing exemplary customer service 
• Ability to work independently and to carry out assignments to completion within parameters of instructions given, prescribed routines, and standard accepted practices 

Preferred Qualifications

• Associate degree preferred 
• Preferred years of experience - Level three 5+ years of experience.

Apply Now

* Participants who complete a short wellness assessment qualify for FREE coverage in our HIP PPO medical plan. Free coverage applies in the next calendar year.

Learn more about our health and wellness benefits, which provide the security to help you and your family live full lives:  www.abbottbenefits.com

Follow your career aspirations to Abbott for diverse opportunities with a company that can help you build your future and live your best life. Abbott is an Equal Opportunity Employer, committed to employee diversity.

Connect with us at www.abbott.com, on Facebook at www.facebook.com/Abbott, and on X @AbbottNews.