Overview
This role involves performing tasks of moderate to difficult complexity related to physician and hospital accounts within the revenue cycle. Responsibilities include data analysis and interpretation, analyzing aged accounts and remittances to determine reasons for denials, non-payment, and overpayment, posting and correcting electronic remittances, billing and follow-up with government payers and specialized accounts, ensuring correct coding guidelines, preparing accounts for appeal, and reviewing insurance credit balances and patient credits.
Responsibilities
- Analyze insurance and patient credit balances to identify root causes and take appropriate action to resolve accounts.
- Contact payers to make inquiries on account status, escalate problem accounts, and document billing activity according to departmental guidelines.
- Ensure compliance with all applicable billing regulations and report any suspected compliance issues to departmental leaders.
- Properly document accounts with clear indicators and activities to facilitate tracking and trending for further analysis.
- Maintain compliance with privacy, HIPAA, and regulatory requirements.
- Participate in general or special assignments and attend all required training.
- Adhere to organizational policies, procedures, and compliant regulatory payer guidance.
- Perform other duties as assigned.
Supervisory Responsibilities
- This is a non-management position reporting to a supervisor, manager, director, or executive.
Requirements
- Education: High school diploma or equivalent, or post-high school diploma/highest degree earned.
- Experience: Minimum of two (2) years in billing, bookkeeping, or accounting.
Knowledge, Skills, and Abilities
- Familiarity with the functions required for roles such as Denial/Appeals Specialist, Payment Research Specialist, and Quality Assurance Specialist.
Work Shift
- Day shift (United States of America)
Location
- Colonial Life Building
- Facility: 7001 Corporate
- Department: 70019935 System Billing Office