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Day
1
Regular
Job Description
Southeast. Always the right career direction.
Job Description Summary
Performs daily activities involved in the reimbursement process, i.e., claims filing/follow-up, entry of payments/adjustments, follow-up on non-payment or payments below contracted fee schedule amount. Identifies any repetitive errors, either system/manual so that corrective action may be taken and documented. Performs all tasks in a timely manner to ensure consistency in Accounts Receivables totals and maintain a minimum of days in A/R.
Job Description
QUALIFICATIONS:
- High School diploma;
- One year of revenue cycle experience preferred;
- Working knowledge of CPT and ICD 10 coding systems;
- Coding Certification preferred;
- Working knowledge of computers.
LANGUAGE/ COMMUNICATION SKILLS:
- Excellent written, verbal and interpersonal skills;
- Ability to interact with customers in both hospital and clinic environments.
SKILLS:
- Basic keyboard/typing skills;
- Basic computer skills;
- Calculator skills.
POSITION DUTIES:
- Works as part of a multi-disciplinary team to provide answers to inquiries and questions;
- Troubleshoot problems and provide information;
- Handle intervention or referrals with a professional and respectful customer service focus telephonically and/or in person;
- Provides a variety of support services in connection to the day-to-day operations in a health care environment;
- Maintains working knowledge of regulatory guidelines for billing;
- Provides claim submission for services provided at SEH;
- Provides follow up on claims which did not process correctly;
- Provides follow up with insurance companies or individuals to obtain accurate reimbursement;
- Reviews correspondence daily for appropriate follow up;
- Works closely with clinical team for accurate charges and modifiers;
- Verifies third party payer coverage;
- Coordinates authorizations when appropriate;
- Works closely with coding team for accurate submission on claim;
- Process and follow up on payer denials, consulting with various entities for completion;
- Research and resolve client billing problems or issues;
- Provide communication on the methods and principles used for billing to the customers and resolve concerns;
- Study contractual terms and conditions of payment to ensure payments are made consistent with terms;
- Conduct work functions to assist with late charge processes;
- Works closely with third party collection vendors for accurate payment records;
- Assist patients and their families with applying for financial assistance;
- Establish payroll deduction transactions;
- Make daily deposits to the bank;
- Ensure change fill requests are complete for department’s daily function;
- Work with patients to develop self-pay arrangements and payment plans when applicable;
- Post payments for both insurance and individuals;
- Review accounts and initiate refunds when applicable;
- Communicate self-pay balances for upcoming services and collect balances due;
- Work with accounting department for accurate financial documentation;
- Edit account for correct coverage documentation;
- Apply contractual adjustments in accordance with contracts;
- Print, scan and index correspondence to the appropriate account;
- Works closely with electronic payment process vendor for accurate posting and adjustments electronically;
- Oversee the electronic flow of the account through the billing process to include bad debt;
- Performs all other duties as assigned.