Position Summary / Career Interest:

• Reviews Explanation Of Benefits & Remittance Advisements for denied claims.
• Works with manage care organizations to identify and/or resolve claim submission requirements. Evaluates and resolves issues related to revenue cycle including charge capture charge master coding claim submission or information system.
• Prepares and maintains statistical and financial reports supporting areas of performance improvement.
• Identifies areas of improvements utilizing financial statistical indicators related to revenue cycle performance.
• Reviews intradepartmental and interdepartmental processes for improvements that will decrease denials and underpaid claims that occur due to a variety of reasons related to: Authorization Eligibility Medical Necessity Utilization Review Documentation
• Analyzes situations and makes recommendations that will achieve financial objectives related to revenue cycle.
• Provides training to external and internal customers to educate and improve revenue cycle processes.
• Provides input in analysis of aging trends. Submits ticket requests with Hospital Systems on systems changes to ensure billing accuracy.
• Prepares third party appeals as appropriate.
• Must be able to perform the professional clinical and or technical competencies of the assigned unit or department.
• These statements are intended to describe the essential functions of the job and are not intended to be an exhaustive list of all responsibilities. Skills and duties may vary dependent upon your department or unit. Other duties may be assigned as required.

• High School Graduate or GED.
• Associates Degree in related field OR Associates Degree equivalent of 4 years of experience in claims denials chargemaster coding or insurance processing.
• 4 or more years of experience in financial reporting processing over and under payments claims denials chargemaster coding or insurance processing.

• Bachelors Degree in related field from an accredited college or university.
• Epic experience.

Time Type:

Job Requisition ID:

Important information for you to know as you apply:

• The health system is an equal employment opportunity employer. Qualified applicants are considered for employment without regard to race color religion sex (including pregnancy gender identity and sexual orientation) national origin ancestry age disability veteran status genetic information or any other legally-protected status. See also Diversity Equity & Inclusion.

• The health system provides reasonable accommodations to qualified individuals with disabilities. If you need to request reasonable accommodations for your disability as you navigate the recruitment process please let our recruiters know by requesting an Accommodation Request form using this link .

• Employment with the health system is contingent upon among other things agreeing to the and signing the agreement to the DRP.

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