Job Description

POSITION SUMMARY:

Perform duties to process medical billing and credit collections with focus on accuracy, timeliness and adherence to process. Reduce DSO, recognize additional revenue opportunities, and improve in credit collection rates, while working within the limits of standard or accepted practice. Demonstrate the company’s core values of respect, honesty, integrity, diversity, inclusion, and safety.

ESSENTIAL FUNCTIONS:

• Review patient files for completeness and accuracy, identify and audit claims, ensure all revenue opportunities are included
• Review documents received including Explanations of Benefits (EOBs), Remittance Advices (RAs) and other documents indicating credit balances
• Identify reasons for credits, take required corrective action, and take ownership of claims through to timely, successful resolution
• Analyze credits, identify trends and recommend process improvement opportunities that will result in credit DSO reduction, superior credit rate and intervals and simplified processes that are responsive to the requirements of specific payers
• Review claims with outstanding credit balances and identify actions to successfully resolve
• Follow up with insurers and patients to resolve outstanding balances in an environment of excellent customer service focused on building enduring customer and business relationships
• Document case activity, communications and correspondence in computer system to ensure completeness and accuracy of account activity and actions taken to resolve outstanding claims issues
• Contribute medical claims expertise to the design of training and knowledge transfer programs, materials, policies and procedures to improve the efficiency and effectiveness of the Revenue Cycle Management team
• Perform or assist with any departmental projects or operations, as required to maintain workflow and to meet schedules and quality requirements
• Participate in any variety of meetings and work groups to integrate activities, communicate issues, obtain approvals, resolve problems and maintain specified level of knowledge pertaining to new developments, requirements, and policies
• Perform other related duties as assigned
• Must be able to perform the essential job functions of this position with or without reasonable accommodation

BEHAVIORS/SKILLS PUTS THE CUSTOMER FIRST: Anticipates customer needs, champions for the customer, acts with customers in mind, exceeds customers’ expectations, gains customers’ trust and respect.  

COMMUNICATES EFFECTIVELY AND CANDIDLY: Communicates clearly and directly, approachable, relates well to others, engages people and helps them understand change, provides and seeks feedback,articulates clearly, actively listens.

ACHIEVES RESULTS THROUGH TEAMWORK: Is open to diverse ideas, works inclusively and collaboratively, holds self and others accountable, involves others to accomplish individual and team goals.

LEADS THROUGH POSITIVE INFLUENCE: Demonstrates strong character; builds partnerships; models a conscious balance between work and personal life; takes personal responsibility for own development; role models leadership qualities such as motivation, inspiration, passion and trust.

COACHES AND DEVELOPS OTHERS: Develops and cares about associates, builds effective teams, helps people be their best, values and manages diversity, provides candid and constructive feedback.

LEADS CHANGE AND INNOVATION: Challenges the status quo, embraces technology, puts forward creative ideas, champions and implements process improvements, gathers the ideas of others, demonstrates good judgment about which ideas will work.

EXECUTES WITH EXCELLENCE: Is action oriented, drives for results, sets clear expectations and milestones, reviews progress, acts decisively, solves problems, can be counted on to consistently meet or exceed goals.

PROVIDES CLEAR AND STRATEGIC DIRECTION: Plans and organizes well, sets a clear and simple course of action, stays focused on the most important priorities, has the ability to visualize and plan for the future, understands the industry and marketplace.

SAFETY AWARENESS: Identifying and correcting conditions that affect employee safety; upholding safety standards.

Qualifications

MINIMUM POSITION QUALIFICATIONS

• High School Diploma or GED
• 3+ years of medical collections experience
• Any working knowledge of automated billing systems
• Demonstrated excellence in attention to detail and the ability to successfully manage multiple priorities with critical focus on accuracy
• Highly effective communicator with superior listening, understanding, speaking and writing while influencing patients, care givers, payer
• representatives and others, answering questions and advancing reimbursement and collection efforts
• Proven understanding of processes, systems and techniques to ensure successful billing and collection working with all payer types
• Proven ability to identify gaps and problems from review of documentation, determine lasting solutions, make effective decisions, and take necessary
• corrective action
• Proficient with Microsoft Office Word, Excel, and Outlook

DESIRED PREVIOUS JOB EXPERIENCE/EDUCATION

• Any additional specialized training in medical billing
• Any working knowledge of managed care, commercial insurance, and Medicare and Medicaid reimbursement
• Any experience with CPR+
• Coding Course Certification

POTENTIAL CAREER PATH FROM THIS POSITION

• Supervisor, Reimbursement Specialist

Additional Information

All your information will be kept confidential according to EEO guidelines.