This position serves as Adirondack Health’s primary contact for patient and insurance reimbursement issues in accordance with established policies and payer requirements. The role is responsible for managing and resolving insurance claim denials, with a focus on surgical and high-dollar accounts, including accounts with unlisted procedure codes.
The position supports the revenue cycle’s financial integrity by analyzing denial trends, coordinating appeals, and collaborating with internal teams to improve first-pass resolution rates and reduce recurring denials. Communication must be professional and patient-focused to support positive patient relations and prompt reimbursement for services.
Education
- High school diploma required
- Bachelor’s degree in business or a related field preferred, or equivalent combination of education and experience
Experience
- Minimum 3 years of experience in PFS directly involved in billing and collections of accounts receivable
- Minimum 3 years of experience in a lead capacity preferred
- Experience with third-party payers, patient accounts, billing, payer rules, coding guidelines, and appeal processes
Skills
- Strong understanding of payer explanation of benefits (EOBs)
- Proficiency with computer terminals and personal computers
- Excellent communication skills for responding to inquiries
- Strong interpersonal, analytical, and problem-solving skills
- Advanced knowledge of Microsoft Excel and Microsoft Office
- Ability to interact effectively with patients, insurance companies, and employees at various levels
- Professionalism and flexibility to work schedules based on operational need
Benefits
- Medical, dental, and vision insurance
- Paid time off and sick days
- Tuition reimbursement
- 403(b) retirement plan with employer contributions
- Additional employee benefits
Location
New York, US
Employment Type
Full-time
Experience Level
Intermediate Level
Remote work allowed
No
Posted
3 weeks ago