Navigant Third Party Lead (MS0)- Navigant Cymetrix- Birmingham, AL in Lewisville, Texas

Navigant Consulting, Inc. (NYSE: NCI) is a specialized, global professional services firm that helps clients take control of their future. Navigant’s professionals apply deep industry knowledge, substantive technical expertise, and an enterprising approach to help clients build, manage and/or protect their business interests. With a focus on markets and clients facing transformational change and significant regulatory or legal pressures, the Firm primarily serves clients in the healthcare, energy and financial services industries. Across a range of advisory, consulting, outsourcing, and technology/analytics services, Navigant’s practitioners bring sharp insight that pinpoints opportunities and delivers powerful results. More information about Navigant can be found at navigant.com.

Navigant Cymetrix unites the strengths of four category-leading companies to address the complexities of today’s healthcare system. We design, develop and implement integrated, patient-centered solutions for sustained improvements in performance and profitability, working collaboratively across a spectrum of customers that encompasses hospitals, health systems, physician practice groups and payers.

Under general supervision and according to established policies and procedures, the Third Party Lead (MSO) performs a variety of duties related to the third party follow up function of the MSO. Such duties may include, but are not limited to, the following: 1) Assists Third Party Supervisor/Manager in coordinating all activities related to the Third Party 2) Manage ETM views daily 3) Reviews work of Support/Third Party Representatives and provides training and feedback based upon analysis 5) Assists in the implementation of current and new standards and guidelines 6) Routinely assists employees in the area to help ensure performance goals are met and answers representatives questions in a timely manner 7) Performs other duties as requested by supervisor/manager .

  • Must be self-directed/self-motivated.

  • Must be able to: (1) perform a variety of duties often changing from one task to another of a different nature without loss of efficiency or composure; (2) accept responsibility for the direction, control and planning of one’s own work; (3) work independently; (4) recognize the rights and responsibilities of patient confidentiality; (5) relate to others in a manner which creates a sense of teamwork and cooperation; (7) communicate effectively with people from every socioeconomic, cultural and educational background; (8) exhibit flexibility and cope effectively in an ever-changing, fast-paced healthcare environment; (9) perform effectively when confronted with emergency, critical, unusual or dangerous situations; (10) demonstrate the quality work ethic of doing the right thing the right way; and (11) maintain a customer focus and strive to satisfy the customer's perceived needs.

  • Performs functions assigned by Supervisor/Manager to ensure team objectives are met.

  • Works ETM Management View daily.

  • Works assigned ETM views where needed.

  • Distribution of paper claims daily.

  • Work claim edits and audit trails.

  • Special reports assigned by management.

  • Train new employees.

  • Provide continuing education for current employees.

  • Research to locate medical records when required.

  • Respond to employees questions in a timely manner.

  • Ensures third party follow-up is performed accurately.

  • Review ETM session detail.

  • Review monthly adjustment report.

  • Review CCMI report and record results.

  • Ensure users are working ETM view properly (tickler returns, transfers etc.)

  • Ensure users are working Correspondence workbaskets properly.

  • Analyze/review other reports given by management.

  • Provides responses in a timely manner by using available resources.

  • Receives incoming and outgoing calls and addresses billing inquiries from third party payers and MSO divisions.

  • Responds to work related emails in a timely and appropriate manner.

  • Report identified billing issues to appropriate staff.

  • Attends team meetings and other MSO functions as assigned.

  • Takes minutes including a record of those in attendance and distributes to entire team.

  • Completes all required training and any ongoing educational needs.

  • Monitor and place order for office supplies.

  • Required: High School Diploma or equivalent.

  • Preferred: 1 year of related experience in insurance billing, customer service related field or educational equivalent.

  • Entry level management experience a plus.

  • General knowledge of payer specific or medical specialty billing.

  • Good organizational and analytical skills.

  • Good communications skills (written and oral) and basic computer skills.

  • Knowledge of ICD-10 and CPT coding preferred.

  • Knowledge of IDX/GE billing system.preferred.

  • Strong conceptual, as well as quantitative and qualitative analytical skills

  • Work as a member of a team as well as be a self-motivator with ability to work independently

  • Constantly operates a computer and other office equipment to coordinate work

  • Regularly uses close visual acuity and operates computer equipment to prepare and analyze and transmit data

  • Generally works in an office environment

The company offers competitive compensation packages including an incentive compensation plan, comprehensive medical/dental/life insurance, 401(k) and employee stock purchase plans.

Navigant does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Navigant and Navigant will not be obligated to pay a placement fee.

Navigant is an Equal Employment Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, citizenship status, military status, protected veteran status, religion, creed, physical or mental disability, medical condition, marital status, sex, sexual orientation, gender, gender identity or expression, age, genetic information, or any other basis protected by law, ordinance, or regulation.

Navigant will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.