Provides accurate and timely submission of claims for Prisma Health to various payer sources based on timely filing guidelines.
Responsible for follow-up on specialty accounts, including aged and high-dollar accounts, and for comparing expected reimbursement to actual reimbursement received.
Works with internal departments and external payers to resolve missing payments, payer delays, technical denials, claim rejections, and reimbursement variances.
Ensures insurance payments are correct, posted to accounts, and that balances are moved appropriately to secondary payer or patient liability when needed.
Supports billing workflow improvements, escalates accounts when appropriate, and helps maintain acceptable accounts receivable aging levels.
Day shift position in Patient Financial Services.
Minimum requirements
- High school diploma or equivalent
- 3 years of hospital claims and billing follow-up experience
- Understanding of hospital and physician claim forms
- Knowledge of payer guidelines
In lieu of minimum requirements
- Bachelor's degree and 2 years of hospital billing follow-up/denials experience
Other required skills and experience
- Facility claims and billing follow-up and/or medical office experience required
- Communication skills and attention to detail preferred
- CRCA or CRCR preferred
Location
South Carolina, US
Employment Type
Full-time
Experience Level
Intermediate Level
Remote work allowed
No
Posted
2 months ago