Job Category:

Revenue Cycle

Work Shift/Schedule:

8 Hr Morning - Afternoon

Northeast Georgia Health System is rooted in a foundation of improving the health of our communities.

About the Role:

Job Summary

This position is responsible for the accurate and timely resolution of undistributed payments, guarantor and insurance credit balances, and refund requests, including account research, root cause analysis, clear and concise documentation and coordination with other areas of the Revenue Cycle in order to ensure payment, credit, and adjustment integrity for hospital and physician operations.
 

Minimum Job Qualifications

• Licensure or other certifications:

• Educational Requirements: High School Diploma or GED.

• Minimum Experience: One (1) year minimum in healthcare billing/collection or payment posting required.

• Other:

Preferred Job Qualifications

• Preferred Licensure or other certifications:

• Preferred Educational Requirements:

• Preferred Experience:

• Other:

Job Specific and Unique Knowledge, Skills and Abilities

• Strong knowledge of commercial and governmental billing and collections for both facility and professional services, including explanation of benefit documentation and managed care contracts

• Strong knowledge of payment and adjustment posting and associated documentation to ensure data integrity

• Strong knowledge of patient billing and collections regulations and policies and procedures in a single billing office environment to ensure complete and compliant resolution of balances

• Personal computer proficiency to include all Microsoft Office programs and Revenue Cycle systems necessary to perform job duties, including proper documentation 

• Knowledge of HIPAA regulations to protect patient health information

• Excellent problem-solving skills with attention to details

• Excellent customer service skills and telephone proficiency

• Excellent verbal and written communication skills

• Excellent arithmetic skills

• Ability to work independently with minimal assistance or direction
   

Essential Tasks and Responsibilities

• Maintains a thorough understanding of health insurance and EOBs, single billing office collection policies, and 501r regulations and financial assistance policy.

• Thoroughly reviews all EOBs and payment and adjustment postings to ensure billing and collections integrity of each account.

• Researches, processes and documents guarantor refunds created by guarantor overpayments, applying overpayment to any open balance first and identifying root cause.

• Researches, processes and documents insurance refunds created by overpayments, identifying root cause.

• Researches, resolves and documents undistributed insurance and guarantor payments, identifying root cause.

• Applies appropriate adjustments and/or corrects responsible party assignments to resolve credit accounts.

• Responds to all correspondence and telephone calls relating to requests for refunds professionally and timely.

• Reports issues and trends leading to undistributed payments and/or credits in order to improve processes, decrease waste and reduce over-collections.

• Promotes and contributes positively to the teamwork of the department by assisting coworkers, contributing ideas and problem-solving.

• Provides excellent customer service to all internal and external customers (e.g., patients/guarantors, payers, and other departments).

• Remains in good standing with all NGHS policies including those related to attendance, positive attitude and staff development.

• Performs other duties as assigned.

Physical Demands

• Weight Lifted: Up to 20 lbs, Occasionally 0-30% of time

• Weight Carried: Up to 20 lbs, Occasionally 0-30% of time

• Vision: Moderate, Frequently 31-65% of time

• Kneeling/Stooping/Bending: Occasionally 0-30%

• Standing/Walking: Occasionally 0-30%

• Pushing/Pulling: Occasionally 0-30%

• Intensity of Work: Occasionally 0-30%

• Job Requires: Reading, Writing, Reasoning, Talking, Keyboarding

Working at NGHS means being part of something special: a team invested in you as a person, an employee, and in helping you reach your goals. 

NGHS: Opportunities start here.

Northeast Georgia Health System is an Equal Opportunity Employer and will not tolerate discrimination in employment on the basis of race, color, age, sex, sexual orientation, gender identity or expression, religion, disability, ethnicity, national origin, marital status, protected veteran status, genetic information, or any other legally protected classification or status.