Posted Date: 7/11/2024

Job Location: St. Anthony Regional Hospital, 311 South Clark St, PO Box 628, Carroll, IA, 51401
Department: Patient Finance
Employment Type: Full-Time
Job Description

Job Summary

Processes facility insurance claims.

Essential Duties and Responsibilities

• Performs daily posting of payments, imports remits and reconciles payments.

• Stays current with payer requirements for billing and shares best practices. Is involved with root cause analysis of denied claims and communicates trends and suggestions for improvement.

• Imports claims into the clearinghouse and review claims to achieve clean claims.

• Processes and corrects insurance denials.  Works Accounts Receivable account aging to achieve maximum reimbursement for services provided. Documents all efforts on patient accounts.

• Scans documentation into the archiving system for storage.

• Provides customer service to internal and external customers regarding claims and insurance processing. Works with departments to resolve and avoid denials and appeals. Collaborates with team members to make process decisions. 

• Works with customers regarding billing questions.

• Works willingly and accepts assignments as given.

• Attends all mandatory meetings and programs.

• Participates in opportunities that enhance personal and professional growth.

• Performs other duties as necessary or assigned.

• Complies with the Corporate Compliance Policy and all laws, regulations, and Standards of Conduct relating to the position and agrees to report any suspected violations of law or Standards of Conduct.

• Complies with all applicable state and federal regulations.

• Maintains a safe work environment using safe work practices, utilizing standard precautions and complying with hazardous waste procedures at all times as described in St. Anthony's Safety Manual.

• Maintains the confidentiality of patient, resident, employee and organizational information.

Supervisory Responsibilities

This job has no supervisory responsibilities.

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education and/or Experience

• Medical billing and coding certificate, diploma, or degree with three to six months related experience and/or training; or equivalent combination of education and experience. 

Language Skills

Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before customers, patients, families and employees of the organization.

Physical Demand

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is regularly required to sit and use hands to finger, handle or feel.  The employee frequently is required to talk and hear.  The employee is occasionally required to stand, walk, and reach with hands and arms.  The employee must occasionally lift and/or move up to 25 pounds.  Specific vision abilities required by this job include close vision, depth perception, and ability to adjust focus.

Work Environment

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

The noise level in the work environment is usually moderate.

Apply Online

If you have further questions, please call the Human Resources Department at 712-794-5111.

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