- Identifies the correct Financial Class and enters in billing system.
- Posts extracts and correct validation errors in system.
- Identify trends and communicates to leadership team.
- Reviews incoming documentation to identify correct payer to accounts.
- Researches eligibility to ensure correct insurance coverage of payer.
- Ensures payer mapping (crosswalk) is set-up correctly.
- Identifies contract matrix discrepancies and/or gaps and communicates accordingly.
- Analyzes decision log errors related to the daily census.
- Identifies trends with incoming data and communicates to leadership team.
- Analyzes pre-submission errors to identify root cause and recommends a solution.
- Processes denials related to eligibility to identify correct payer or payer request.
- Processes electronic rejections, identifies root cause, and recommends/makes appropriate updates to accounts.
- Processes returned mail, write-off accounts, and daily exception reports.
- Processes Laserfiche folders (duplicate, pending review, etc.) to ensure documentation is processing timely.
- Identifies Work in Process (WIP) and creates exception reports for management.
- Processes activity codes for Account Classification or account suspended issues.
- Retrieves missing documentation for payer accounts from various applications and/or site portal.
- Prints, sorts, and files miscellaneous billing related documentation.
- Completes daily log via manual entry into billing system.
- Time tracking for manual sites.
- Trains fellow team members as requested or needed.
- High school diploma or GED required.
- One or more years of experience in billing operations required.
- Prior experience working in the healthcare industry preferred.
- Knowledge of payer Financial Classifications for billing.
- Knowledge of account exception processes in billing operations.
- Ability to read and interpret Explanation of Benefits (EOB) from various payers.
- Ability to communicate trends to leadership team clearly.
- Ability to problem solve challenges that may not be previously outlined in a payer manual.
- Ability to communicate effectively in writing and verbally.
- Ability to analyze, interpret, and create various billing related reports.
- Knowledge of and ability to apply basic math concepts.
- Ability to complete duties with attention to detail and high degree of accuracy.
- Ability to prioritize workflow and work autonomously.
- Basic understanding of Microsoft Office applications (Word, Excel, and Outlook).
- Ability to comply with RCM billing policies and procedures.
- Monthly wellness events and programs such as yoga, HIIT classes, and more.
- Trainings to help support and advance your professional growth.
- Team building activities such as virtual scavenger hunts and holiday celebrations.
- Flexible work hours.
- Superior health plan options
- Dental, Vision, HSA/FSA, Life and AD&D coverage, and more
- Top Tier 401(k) retirement savings plans that offers a $1.20 match for every dollar up to 6%
- Outstanding Paid Time Off: 3-4 weeks' vacation, Paid holidays, Sabbatical
- Student Loan Refinancing Discounts
- Professional and Career Development Program
- EAP, travel assistance, and identify theft included
- Wellness program
- Commuter Benefits Program
- Purpose-driven culture focused on improving the lives of our patients, communities, and employees.
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