Patient Financial Services Reimbursement Specialist II

Description

Summary:

Coordinates and monitors all aspects of Patient Financial Services daily functions including billing compliance and accounts receivable functions.Responsible for the assigned areas claims submission payment application denial management and account followup to ensure optimal reimbursement.

Responsibilities:

1. Coordinates/monitors all aspects of billing/accounts receivable management; ensures compliance efficiency & reimbursement; includes accurate & timely preparation/submission of claims payment & rejection application & followup for reimburse receivables. 2. Receives and processes payments & rejections for assigned work group accurately & timely. Performs trend analysis for management in order to determine registration & documentation deficiencies throughout the organization. 3. Responsible for daily completion & correction of information for claims edit lists & rejections; identifies training issues within the department. Provide immediate access to explanation of benefits (EOBs) reports & other information as requested. 4. Processes claims on a daily basis & perform timely followup. Supports Team Leader; ensures appropriate completion of department workflow. Offers guidance & training to lower level staff & provides input to Level I staff members performance if requested. 5. Provide feedback to designated Hospital contacts regarding billing and reimbursement issues & changes in procedures rules & regulations including immediate feedback to management regarding payment rejections as necessary. 6. Participate in meetings with supervisors and/or managers to review issues including staff training & education A/R management & reimbursement issues. 7. In addition to the processing of refunds credit balances and unapplied cash support the Team Leader in monitoring the accuracy & completion of the entire cash application process. 8. Adheres to all policies and procedures related to compliance with all federal & state billing & collection regulations & third party contractual obligations. 9. Identifies and resolves problems associated with billing procedures system functionality etc & reinforces training for staff as necessary & make recommendation to management for improvement &/or resolution. WCHN Position Description Page 1 of 2 July. Maintains departmental policies and procedures. 11. Adheres to all policies and procedures related to compliance with all federal & state billing & collection regulations & third party contractual obligations. 12. Fulfills all compliance responsibilities related to the position. 13. Performs other duties as assigned.

Other Information:

Required: Data entry and MS Excel. Customer service experience required. Minimum Experience: one year Desired: Medical terminology billing cash applications and collection experience.

Working Conditions:

Manual: significant manual skills/motor coord & finger dexterity

Occupational: Little or no potential for occupational risk

Physical Effort: Sedentary/light effort. May exert up to 10 lbs. force

Physical Environment: Generally pleasant working conditions

Company: Nuvance Health

Org Unit: 1826

Department: Patient Accounting Med Practic

Exempt: No

Salary Range: $18.97 $35.21 Hourly