JOB SUMMARY

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This position will be hospital charge reconciliation. Insuring all the items we complete in the hospital are billed out. Secondly, it will be denials research and finding patterns in claims denials to see what we can improve to prevent the denial. 

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Accountable for ensuring all billing charges are captured in an appropriate manner for, but not limited to, the areas of delivery, JV hospital locations, transitional care facilities, internal hospital departments, external nursing facilities, and ambulatory surgical centers. Assures compliant charge capture and minimizes delays in the billing process by identifying, knowing, and reconciling billing charges, verification of insurance benefits, and for the assigned department or area of responsibility. Must have post-AR billing experience. 

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ESSENTIAL FUNCTIONS OF THE ROLE

\n\nContacts facility staff to obtain information regarding pre-admissions, admissions, billing, and guarantor information.\nCoordinate with hospital admission staff, when necessary, to speak with an insurance/payer representative to negotiate out-of-network or single-payment agreements.\nCommunicate with providers when necessary to obtain additional information to ensure proper billing and coding.\nGathers, examines, and verifies information to include confirmation of insurance and authorizations for admission and/or procedures required for billing to ensure accurate and timely reimbursement.\nPerforms general office duties such as obtaining and scanning records from JV and other facilities to appropriate team members.\n\n

KEY SUCCESS FACTORS

\n\nMust have the ability to consistently meet performance standards of production and accuracy.\nAbility to know about and adhere to payer guidelines by plan and service type.\nExcellent data entry, numeric entering, and computer navigation skills.\nDemonstrate the ability to work autonomously.\nRequires good listening, communication skills, and professional telephone etiquette.\nKnowledge of patient registration procedures and documentation.\nPost AR billing experience.\nSkilled in use of personal computers and related software applications.\n\n

BENEFITS

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Our competitive benefits package includes the following:

\n\nImmediate eligibility for health and welfare benefits\n401(k) savings plan with dollar-for-dollar match up to 5%\nTuition Reimbursement\nPTO accrual beginning Day 1\n\n

Note: Benefits may vary based upon position type and/or level

QUALIFICATIONS

\n\nEDUCATION - Associate's or 2 years of work experience above the minimum qualification\nEXPERIENCE - 3 Years of Experience\n