Long Island Community Hospital has served this richly diverse region as a patient-first community hospital for more than 60 years. As Long Island's only independent community hospital, we are 100% committed to becoming the community's healthcare provider of choice with our greatly enhanced services including the Knapp Cardiac Care Center, our highly-advanced heart disease diagnosis and treatment facility, our new modern surgical pavilion, our unique ER approach, and our high-touch services including women's imaging, sleep laboratory and orthopedics and more. These services are delivered with the highest level of compassion by our LI Community Hospital staff - Long Islanders with an unmistakable mix of courage and heart who care about the people right here in our community and whose sole purpose is to provide personalized comfort. For more information, go to licommunityhospital.org , and interact with us on LinkedIn , Glassdoor , Indeed , Facebook , Twitter , YouTube and Instagram .
Position Summary:
We have an exciting opportunity to join our team as a Non-Gov't Follow-Up Rep Full Time Day 08:00 AM - 04:00 PM - FIN-Rev Cyc Ops-Inpatient.
Performs follow-up and payment analysis on non-governmental hospital claims to ensure timeliness and accuracy of payments from the Managed Care plans. Has an understanding of Managed Care contracts to perform payment analysis and follows up on reconsiderations and appeals. Escalates trends and claim issues to management for resolution.
Attends to all telephone inquiries, audits, and mail correspondence as they apply to the accounts receivable. Adheres to all department policies, procedures and HIPAA regulations.
Job Responsibilities:
Ensures follow- up, denials, underpayment, correspondence and credit reviews are conducted in a timely manner, notating all pertinent information in the Patient Accounting system to meet the Quality Review standards.
• Resolves outstanding accounts utilizing ancillary applications and websites as tools to submit/retrieve medical documentation, obtains claim status, submission of inquiries, claim reconsideration and corrected claim submissions.
• Researches and interprets payer contract terms and performs extensive follow-up to investigate and resolve payment denials, underpayments and credits.
• Requests medical records and itemized bills as needed. Escalates delays in process to Management.
• Participates in bi-weekly calls with Management and JOC analysts to review and resolves issues related to the outstanding receivable.
• Process all third party correspondence in a timely manner.
• Daily review of claim edit work queues including 277 claim rejections to ensure accurate and timely submission and/or resubmission of claims to third party payors.
• Daily review of accounts receivable in the assigned payer work queues.
• Maintain patient accounts with an active self-pay balance to ensure all accounts go through the proper self-pay collection channels, including review of self-pay credits for transfer or processing of refund amount.
• Performs other duties as assigned
• Complies with hospital and department corporate compliance, safety and infectious control procedures. Stays up to date with corporate compliance standards and attends scheduled training.
• Demonstrates a clear knowledge and understanding of the department and hospital policies and procedures as it relates to daily job responsibilities.
Minimum Qualifications:
High School or equivalent required. 2+ years relevant experience. Strong customer service and communication skills. Proficient in MS Excel, Word, and outlook. Familiarity or prior experience with office setting. Prior customer service experience. Must be articulate with good interpersonal skills. Must have knowledge of computer keyboard able to type a minimum of 20 words per minute. Must be able to accurately enter data. Willingness to devote the time required completing assigned tasks on schedule.
Qualified candidates must be able to effectively communicate with all levels of the organization.
Long Island Community Hospital provides its staff with far more than just a place to work. Rather, we are an institution you can be proud of, an institution where you'll feel good about devoting your time and your talents.
Long Island Community Hospital is an equal opportunity and affirmative action employer committed to diversity and inclusion in all aspects of recruiting and employment. All qualified individuals are encouraged to apply and will receive consideration without regard to race, color, gender, gender identity or expression, sex, sexual orientation, transgender status, gender dysphoria, national origin, age, religion, disability, military and veteran status, marital or parental status, citizenship status, genetic information or any other factor which cannot lawfully be used as a basis for an employment decision. We require applications to be completed online.
If you wish to view Long Island Community Hospital's EEO policies, please click here. Please click here to view the Federal "EEO is the law" poster or visit https://www.dol.gov/ofccp/regs/compliance/posters/ofccpost.htm for more information.
Long Island Community Hospital provides a salary range to comply with the New York state Law on Salary Transparency in Job Advertisements. The salary range for the role is $51,402.00 - $51,402.00 Annually. Actual salaries depend on a variety of factors, including experience, specialty, education, and hospital need. The salary range or contractual rate listed does not include bonuses/incentive, differential pay or other forms of compensation or benefits.
To view the Pay Transparency Notice, please click here
Required Skills
Required Experience