Provide support for all aspects of the Revenue Cycle billing and collections process, responsible for billing and collection of accounts receivable outstanding balances. Serve as a resource for department/service lines and other revenue cycle staff.
Maintain confidentiality and safeguard patient personal medical and financial information at all times.
Research and resolve unpaid claims, prepare appeals for rejected/denied claims. Perform timely and accurate posting of patient and insurance payments, process audit and reconciliation reports. Review patient encounter reports for accuracy; enter medical charges to initiate claim submission ensuring regulatory compliance and maximum reimbursement.
Process credit balance work queues, determine final claim status for write offs, collections, or refunds.
Resolve billing and reimbursement issues, provide customer service, and collect outstanding balances. Work with third party payors and intermediaries to pursue prompt payment of professional claims for assigned financial classes, meeting benchmarks and reporting requirements.
Collaborate with internal and external stakeholders to resolve workgroup issues.
Coordinate with patient financial services team to identify and resolve billing, collections, and payment posting issues.
May act as a resource to Financial Services Representatives I and preceptor for new employees.
Perform other related duties as assigned.
High school diploma or equivalent required; CRCR Certification preferred.
Minimum 3 years recent experience interpreting payer contracts, professional and hospital reimbursement and billing compliance, developing and maintaining third party payer relationships, and familiarity with Patient Financial Services processes for claim generation, billing edits, payer processing, and claim/medical records audit.
Proficient with Windows-based PC.
Advanced medical terminology, ICD-10, CPT/HCPCS coding systems.
Advanced EMR/billing systems knowledge (Epic preferred).
Advanced claims clearinghouse system knowledge.
Advanced understanding of payer billing requirements, claims resolution, explanation of benefits (EOBs), medical claim fields, and professional revenue cycle.
Location
Ohio, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
No
Posted
2 weeks ago