Denials & Follow-up Rep- Remote
for section headings: About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule. We must include sections only when posting has real specific content. Let's parse the posting.
Content: Opening paragraph about mission etc. Could be "About the role". Then responsibilities: list of duties. Then requirements: education, experience, etc. Then knowledge skills and abilities (KSAs) maybe Skills. Then maybe Qualifications? The posting includes "Education Required – High School diploma or equivalent Preferred – Associates Degree Or Bachelor Degree Work Experience Required – 1 year related experience ..." That's qualifications. Also "Knowledge Skills and Abilities (KSAs)" includes many skills. So we could have sections: About the role (intro paragraph), Responsibilities (list of duties), Qualifications (education & experience), Skills (KSAs). Benefits, Pay, Schedule: not mentioned. So we should not include those headings.
We must not repeat job title as heading. No Job ID etc. Remove boilerplate: EEO, accommodation contact, etc. Also remove "Physical and Environmental Demands" maybe not needed as a heading; but we could include if it's substantive? It's about physical demands; but we don't have a heading for that in allowed list. Allowed headings are only those listed. So we should not create a heading for Physical demands. We could incorporate that info into maybe Responsibilities or Qualifications? But it's not exactly those. The instruction: "Prefer a few substantive sections over many thin ones." We could omit physical demands entirely if not fitting allowed headings. However we must preserve ALL substantive information; do not invent or summarize away detail. If we omit it, we lose info. But we could include it under a generic section like "Requirements" maybe? But it's not a requirement; it's physical demands. Could we include it under "Responsibilities"? Not appropriate. The instruction says we should use headings only from the list; we cannot create other headings. So we must fit all info into those sections. Perhaps we can put physical demands under "Requirements" as part of job requirements. Or under "About the role". The instruction: "Use for section headings (e.g. About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule)." It says e.g., meaning those are examples, not exclusive? It says "Use for section headings (e.g. About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule)." Likely they expect us to use those headings when appropriate. It doesn't forbid other headings, but they gave examples. Safer to stick to those. We can place physical demands under "Requirements" or "Qualifications". I'd put under "Requirements" as it's a requirement to perform job.
Also we have "Remains knowledgeable on current federal, state and local laws..." that's part of responsibilities maybe.
Also "Other related duties as required." etc.
We need to preserve all substantive information. Let's extract sections.
About the role: introductory paragraph(s) about mission, exceptional care, etc. Could combine first few sentences: "Exceptional care starts with exceptional people. For us, this is more than a job– it’s a calling. It’s waking up each day, looking for ways to make a difference with a compassionate, inclusive and talented team. Ochsner empowers you to discover your passion, reach your potential, and Pursue Your Purpose. Exceptional care starts with exceptional people and teams. Together we are leading the way." That's about the role/mission.
Responsibilities: list of duties: "This job is primarily responsible for resolving all outstanding insurance account receivables. Responsibilities include, but are not limited to, performing collection and billing activities related to account resolution, and communicating with payors (Government and Commercial), clients, reimbursement vendors, and other external resources such as patients." Then list of duties: "Performs account research with internal and/or external resources via phone and payor websites to determine status of the account with the expected result of obtaining payment of the account. Verifies and/or updates insurance and demographic information for accuracy to resolve barriers in receiving payment of the account. Follows-up with payors and checks claim status as needed throughout the payment process. Appeal denials when needed throughout the payment process and determines when appeals should be sent for further research and/or review. Maintains knowledge of differing payor guidelines to ensure accurate reimbursement by various resources, such as department meetings and updates on payor websites. Identifies trends that may cause or are causing various types of issues on assigned accounts and reports to leader with recommendations for system improvements/edits. Other related duties as required. Remains knowledgeable on current federal, state and local laws, accreditation standards or regulatory agency requirements that apply to the assigned area of responsibility and ensures compliance with all such laws, regulations and standards." Also "This employer maintains and complies with its Compliance & Privacy Program and Standards of Conduct, including the immediate reporting of any known or suspected unethical or questionable behaviors or conduct; patient/employee safety, patient privacy, and/or other compliance-related concerns." That could be part of responsibilities.
Qualifications: Education Required – High School diploma or equivalent Preferred – Associates Degree Or Bachelor Degree Work Experience Required – 1 year related experience in related hospital, clinic, medical office, business services/revenue cycle, front line registration, financial counseling, banking and/or customer service related job Preferred – Prior Experience Working With EPIC System
Skills: Knowledge Skills and Abilities (KSAs): Must have computer skills and dexterity required for data entry and retrieval of required job information. Effective verbal and written communication skills and the ability to present information clearly and professionally to varying levels of individuals throughout the patient care process. Must be proficient with Windows-style applications, keyboard, and various software packages specific to role. Strong interpersonal skills. Ability to multi-task. Ability to perform effectively in a fast paced ever changing environment. Ability to remain calm and professional in high pressure/stressful situations regarding patient financial and medical conversations. Reliable transportation to travel to other facilities to fill in as needed.
Also physical demands could be under Requirements? But we already have Qualifications. Could add a section "Requirements" for physical demands and maybe other requirements like compliance training. However we have Qualifications covering education/experience. Could rename "Requirements" to include physical demands and maybe other non-education/experience requirements. But we already have "Qualifications". The list includes both Qualifications and Requirements as possible headings. We could use both: Qualifications for education/experience, Requirements for physical demands and maybe other requirements like compliance. Let's do that.
Thus sections:
- About the role (intro)
- Responsibilities (list)
- Qualifications (education & experience)
- Requirements (physical demands, compliance, transportation? transportation already in skills but could be requirement)
- Skills (KSAs)
We must not include Benefits, Pay, Schedule.
Now we need to output HTML fragment with headings and - for lists,
for prose.
We must not include any boilerplate like EEO, accommodation contact, etc. Also remove duplicated lines.
Let's craft.
First, About the role: combine the mission paragraphs into a
.
Second, Responsibilities: we need a
- for each duty. The responsibilities include a leading sentence plus list. Could put leading sentence in
then list.
List items:
- Performing collection and billing activities related to account resolution, and communicating with payors (Government and Commercial), clients, reimbursement vendors, and other external resources such as patients.
- Performs account research with internal and/or external resources via phone and payor websites to determine status of the account with the expected result of obtaining payment of the account.
- Verifies and/or updates insurance and demographic information for accuracy to resolve barriers in receiving payment of the account.
- Follows-up with payors and checks claim status as needed throughout the payment process.
- Appeal denials when needed throughout the payment process and determines when appeals should be sent for further research and/or review.
- Maintains knowledge of differing payor guidelines to ensure accurate reimbursement by various resources, such as department meetings and updates on payor websites.
- Identifies trends that may cause or are causing various types of issues on assigned accounts and reports to leader with recommendations for system improvements/edits.
- Other related duties as required.
- Remains knowledgeable on current federal, state and local laws, accreditation standards or regulatory agency requirements that apply to the assigned area of responsibility and ensures compliance with all such laws, regulations and standards.
- This employer maintains and complies with its Compliance & Privacy Program and Standards of Conduct, including the immediate reporting of any known or suspected unethical or questionable behaviors or conduct; patient/employee safety, patient privacy, and/or other compliance-related concerns.
We could combine first bullet with the leading sentence but it's okay.
Third, Qualifications: education and experience. Could be a
- for each.
- Education Required – High School diploma or equivalent
- Preferred – Associates Degree Or Bachelor Degree
- Work Experience Required – 1 year related experience in related hospital, clinic, medical office, business services/revenue cycle, front line registration, financial counseling, banking and/or customer service related job
- Preferred – Prior Experience Working With EPIC System
We could also combine.
Fourth, Requirements: physical demands and maybe other requirements like reliable transportation? But transportation is in skills. We'll put physical demands here.
We need to capture the physical demands description: Light Work - Exerting up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly (Constantly: activity or condition exists 2/3 or more of the time) to move objects. Physical demand requirements are in excess of those for Sedentary Work. Even though the weight lifted may be only a negligible amount, a job should be rated Light Work: (1) when it requires walking or standing to a significant degree; or (2) when it requires sitting most of the time but entails pushing and/or pulling of arm or leg controls; and/or (3) when the job requires working at a production rate pace entailing the constant pushing and/or pulling of materials even though the weight of those materials is negligible. NOTE: The constant stress and strain of maintaining a production rate pace, especially in an industrial setting, can be and is physically demanding of a worker even though the amount of force exerted is negligible. Normal routine involves no exposure to blood, body fluid or tissue and as part of their employment, incumbents are not called upon to perform or assist in emergency care or first aid. The incumbent has no occupational risk for exposure to communicable diseases. Because the incumbent works within a healthcare setting, there may be occupational risk for exposure to hazardous medications or hazardous waste within the environment through receipt, transport, storage, preparation, dispensing, administration, cleaning and/or disposal of contaminated waste. The risk level of exposure may increase depending on the essential job duties of the role.
We could put that as a
under Requirements.
Fifth, Skills: KSAs list.
- Must have computer skills and dexterity required for data entry and retrieval of required job information.
- Effective verbal and written communication skills and the ability to present information clearly and professionally to varying levels of individuals throughout the patient care process.
- Must be proficient with Windows-style applications, keyboard, and various software packages specific to role.
- Strong interpersonal skills.
- Ability to multi-task.
- Ability to perform effectively in a fast paced ever changing environment.
- Ability to remain calm and professional in high pressure/stressful situations regarding patient financial and medical conversations.
- Reliable transportation to travel to other facilities to fill in as needed.
Now ensure we didn't include any boilerplate like EEO, accommodation contact, etc. Also remove duplicated lines like "Exceptional care starts with exceptional people." appears twice; we can keep once.
Now output HTML.
We must not include or . Just the fragment.
Let's construct:
About the role
Exceptional care starts with exceptional people. For us, this is more than a job
for section headings (e.g. About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule)." Likely they expect us to use those headings when appropriate. It doesn't forbid other headings, but they gave examples. Safer to stick to those. We can place physical demands under "Requirements" or "Qualifications". I'd put under "Requirements" as it's a requirement to perform job.
Also we have "Remains knowledgeable on current federal, state and local laws..." that's part of responsibilities maybe.
Also "Other related duties as required." etc.
We need to preserve all substantive information. Let's extract sections.
About the role: introductory paragraph(s) about mission, exceptional care, etc. Could combine first few sentences: "Exceptional care starts with exceptional people. For us, this is more than a job– it’s a calling. It’s waking up each day, looking for ways to make a difference with a compassionate, inclusive and talented team. Ochsner empowers you to discover your passion, reach your potential, and Pursue Your Purpose. Exceptional care starts with exceptional people and teams. Together we are leading the way." That's about the role/mission.
Responsibilities: list of duties: "This job is primarily responsible for resolving all outstanding insurance account receivables. Responsibilities include, but are not limited to, performing collection and billing activities related to account resolution, and communicating with payors (Government and Commercial), clients, reimbursement vendors, and other external resources such as patients." Then list of duties: "Performs account research with internal and/or external resources via phone and payor websites to determine status of the account with the expected result of obtaining payment of the account. Verifies and/or updates insurance and demographic information for accuracy to resolve barriers in receiving payment of the account. Follows-up with payors and checks claim status as needed throughout the payment process. Appeal denials when needed throughout the payment process and determines when appeals should be sent for further research and/or review. Maintains knowledge of differing payor guidelines to ensure accurate reimbursement by various resources, such as department meetings and updates on payor websites. Identifies trends that may cause or are causing various types of issues on assigned accounts and reports to leader with recommendations for system improvements/edits. Other related duties as required. Remains knowledgeable on current federal, state and local laws, accreditation standards or regulatory agency requirements that apply to the assigned area of responsibility and ensures compliance with all such laws, regulations and standards." Also "This employer maintains and complies with its Compliance & Privacy Program and Standards of Conduct, including the immediate reporting of any known or suspected unethical or questionable behaviors or conduct; patient/employee safety, patient privacy, and/or other compliance-related concerns." That could be part of responsibilities.
Qualifications: Education Required – High School diploma or equivalent Preferred – Associates Degree Or Bachelor Degree Work Experience Required – 1 year related experience in related hospital, clinic, medical office, business services/revenue cycle, front line registration, financial counseling, banking and/or customer service related job Preferred – Prior Experience Working With EPIC System
Skills: Knowledge Skills and Abilities (KSAs): Must have computer skills and dexterity required for data entry and retrieval of required job information. Effective verbal and written communication skills and the ability to present information clearly and professionally to varying levels of individuals throughout the patient care process. Must be proficient with Windows-style applications, keyboard, and various software packages specific to role. Strong interpersonal skills. Ability to multi-task. Ability to perform effectively in a fast paced ever changing environment. Ability to remain calm and professional in high pressure/stressful situations regarding patient financial and medical conversations. Reliable transportation to travel to other facilities to fill in as needed.
Also physical demands could be under Requirements? But we already have Qualifications. Could add a section "Requirements" for physical demands and maybe other requirements like compliance training. However we have Qualifications covering education/experience. Could rename "Requirements" to include physical demands and maybe other non-education/experience requirements. But we already have "Qualifications". The list includes both Qualifications and Requirements as possible headings. We could use both: Qualifications for education/experience, Requirements for physical demands and maybe other requirements like compliance. Let's do that.
Thus sections:
- About the role (intro)
- Responsibilities (list)
- Qualifications (education & experience)
- Requirements (physical demands, compliance, transportation? transportation already in skills but could be requirement)
- Skills (KSAs)
We must not include Benefits, Pay, Schedule.
Now we need to output HTML fragment with headings and - for lists,
for prose.
We must not include any boilerplate like EEO, accommodation contact, etc. Also remove duplicated lines.
Let's craft.
First, About the role: combine the mission paragraphs into a
.
Second, Responsibilities: we need a
- for each duty. The responsibilities include a leading sentence plus list. Could put leading sentence in
then list.
List items:
- Performing collection and billing activities related to account resolution, and communicating with payors (Government and Commercial), clients, reimbursement vendors, and other external resources such as patients.
- Performs account research with internal and/or external resources via phone and payor websites to determine status of the account with the expected result of obtaining payment of the account.
- Verifies and/or updates insurance and demographic information for accuracy to resolve barriers in receiving payment of the account.
- Follows-up with payors and checks claim status as needed throughout the payment process.
- Appeal denials when needed throughout the payment process and determines when appeals should be sent for further research and/or review.
- Maintains knowledge of differing payor guidelines to ensure accurate reimbursement by various resources, such as department meetings and updates on payor websites.
- Identifies trends that may cause or are causing various types of issues on assigned accounts and reports to leader with recommendations for system improvements/edits.
- Other related duties as required.
- Remains knowledgeable on current federal, state and local laws, accreditation standards or regulatory agency requirements that apply to the assigned area of responsibility and ensures compliance with all such laws, regulations and standards.
- This employer maintains and complies with its Compliance & Privacy Program and Standards of Conduct, including the immediate reporting of any known or suspected unethical or questionable behaviors or conduct; patient/employee safety, patient privacy, and/or other compliance-related concerns.
We could combine first bullet with the leading sentence but it's okay.
Third, Qualifications: education and experience. Could be a
- for each.
- Education Required – High School diploma or equivalent
- Preferred – Associates Degree Or Bachelor Degree
- Work Experience Required – 1 year related experience in related hospital, clinic, medical office, business services/revenue cycle, front line registration, financial counseling, banking and/or customer service related job
- Preferred – Prior Experience Working With EPIC System
We could also combine.
Fourth, Requirements: physical demands and maybe other requirements like reliable transportation? But transportation is in skills. We'll put physical demands here.
We need to capture the physical demands description: Light Work - Exerting up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly (Constantly: activity or condition exists 2/3 or more of the time) to move objects. Physical demand requirements are in excess of those for Sedentary Work. Even though the weight lifted may be only a negligible amount, a job should be rated Light Work: (1) when it requires walking or standing to a significant degree; or (2) when it requires sitting most of the time but entails pushing and/or pulling of arm or leg controls; and/or (3) when the job requires working at a production rate pace entailing the constant pushing and/or pulling of materials even though the weight of those materials is negligible. NOTE: The constant stress and strain of maintaining a production rate pace, especially in an industrial setting, can be and is physically demanding of a worker even though the amount of force exerted is negligible. Normal routine involves no exposure to blood, body fluid or tissue and as part of their employment, incumbents are not called upon to perform or assist in emergency care or first aid. The incumbent has no occupational risk for exposure to communicable diseases. Because the incumbent works within a healthcare setting, there may be occupational risk for exposure to hazardous medications or hazardous waste within the environment through receipt, transport, storage, preparation, dispensing, administration, cleaning and/or disposal of contaminated waste. The risk level of exposure may increase depending on the essential job duties of the role.
We could put that as a
under Requirements.
Fifth, Skills: KSAs list.
- Must have computer skills and dexterity required for data entry and retrieval of required job information.
- Effective verbal and written communication skills and the ability to present information clearly and professionally to varying levels of individuals throughout the patient care process.
- Must be proficient with Windows-style applications, keyboard, and various software packages specific to role.
- Strong interpersonal skills.
- Ability to multi-task.
- Ability to perform effectively in a fast paced ever changing environment.
- Ability to remain calm and professional in high pressure/stressful situations regarding patient financial and medical conversations.
- Reliable transportation to travel to other facilities to fill in as needed.
Now ensure we didn't include any boilerplate like EEO, accommodation contact, etc. Also remove duplicated lines like "Exceptional care starts with exceptional people." appears twice; we can keep once.
Now output HTML.
We must not include or . Just the fragment.
Let's construct:
About the role
Exceptional care starts with exceptional people. For us, this is more than a job
- for lists,
for prose. We must not include any boilerplate like EEO, accommodation contact, etc. Also remove duplicated lines. Let's craft. First, About the role: combine the mission paragraphs into a
. Second, Responsibilities: we need a
- for each duty. The responsibilities include a leading sentence plus list. Could put leading sentence in
then list. List items: - Performing collection and billing activities related to account resolution, and communicating with payors (Government and Commercial), clients, reimbursement vendors, and other external resources such as patients. - Performs account research with internal and/or external resources via phone and payor websites to determine status of the account with the expected result of obtaining payment of the account. - Verifies and/or updates insurance and demographic information for accuracy to resolve barriers in receiving payment of the account. - Follows-up with payors and checks claim status as needed throughout the payment process. - Appeal denials when needed throughout the payment process and determines when appeals should be sent for further research and/or review. - Maintains knowledge of differing payor guidelines to ensure accurate reimbursement by various resources, such as department meetings and updates on payor websites. - Identifies trends that may cause or are causing various types of issues on assigned accounts and reports to leader with recommendations for system improvements/edits. - Other related duties as required. - Remains knowledgeable on current federal, state and local laws, accreditation standards or regulatory agency requirements that apply to the assigned area of responsibility and ensures compliance with all such laws, regulations and standards. - This employer maintains and complies with its Compliance & Privacy Program and Standards of Conduct, including the immediate reporting of any known or suspected unethical or questionable behaviors or conduct; patient/employee safety, patient privacy, and/or other compliance-related concerns. We could combine first bullet with the leading sentence but it's okay. Third, Qualifications: education and experience. Could be a
- for each.
- Education Required – High School diploma or equivalent
- Preferred – Associates Degree Or Bachelor Degree
- Work Experience Required – 1 year related experience in related hospital, clinic, medical office, business services/revenue cycle, front line registration, financial counseling, banking and/or customer service related job
- Preferred – Prior Experience Working With EPIC System
We could also combine.
Fourth, Requirements: physical demands and maybe other requirements like reliable transportation? But transportation is in skills. We'll put physical demands here.
We need to capture the physical demands description: Light Work - Exerting up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly (Constantly: activity or condition exists 2/3 or more of the time) to move objects. Physical demand requirements are in excess of those for Sedentary Work. Even though the weight lifted may be only a negligible amount, a job should be rated Light Work: (1) when it requires walking or standing to a significant degree; or (2) when it requires sitting most of the time but entails pushing and/or pulling of arm or leg controls; and/or (3) when the job requires working at a production rate pace entailing the constant pushing and/or pulling of materials even though the weight of those materials is negligible. NOTE: The constant stress and strain of maintaining a production rate pace, especially in an industrial setting, can be and is physically demanding of a worker even though the amount of force exerted is negligible. Normal routine involves no exposure to blood, body fluid or tissue and as part of their employment, incumbents are not called upon to perform or assist in emergency care or first aid. The incumbent has no occupational risk for exposure to communicable diseases. Because the incumbent works within a healthcare setting, there may be occupational risk for exposure to hazardous medications or hazardous waste within the environment through receipt, transport, storage, preparation, dispensing, administration, cleaning and/or disposal of contaminated waste. The risk level of exposure may increase depending on the essential job duties of the role.
We could put that as a
under Requirements. Fifth, Skills: KSAs list. - Must have computer skills and dexterity required for data entry and retrieval of required job information. - Effective verbal and written communication skills and the ability to present information clearly and professionally to varying levels of individuals throughout the patient care process. - Must be proficient with Windows-style applications, keyboard, and various software packages specific to role. - Strong interpersonal skills. - Ability to multi-task. - Ability to perform effectively in a fast paced ever changing environment. - Ability to remain calm and professional in high pressure/stressful situations regarding patient financial and medical conversations. - Reliable transportation to travel to other facilities to fill in as needed. Now ensure we didn't include any boilerplate like EEO, accommodation contact, etc. Also remove duplicated lines like "Exceptional care starts with exceptional people." appears twice; we can keep once. Now output HTML. We must not include or . Just the fragment. Let's construct:
About the role
Exceptional care starts with exceptional people. For us, this is more than a job
- for each.
- Education Required – High School diploma or equivalent
- Preferred – Associates Degree Or Bachelor Degree
- Work Experience Required – 1 year related experience in related hospital, clinic, medical office, business services/revenue cycle, front line registration, financial counseling, banking and/or customer service related job
- Preferred – Prior Experience Working With EPIC System
We could also combine.
Fourth, Requirements: physical demands and maybe other requirements like reliable transportation? But transportation is in skills. We'll put physical demands here.
We need to capture the physical demands description: Light Work - Exerting up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly (Constantly: activity or condition exists 2/3 or more of the time) to move objects. Physical demand requirements are in excess of those for Sedentary Work. Even though the weight lifted may be only a negligible amount, a job should be rated Light Work: (1) when it requires walking or standing to a significant degree; or (2) when it requires sitting most of the time but entails pushing and/or pulling of arm or leg controls; and/or (3) when the job requires working at a production rate pace entailing the constant pushing and/or pulling of materials even though the weight of those materials is negligible. NOTE: The constant stress and strain of maintaining a production rate pace, especially in an industrial setting, can be and is physically demanding of a worker even though the amount of force exerted is negligible. Normal routine involves no exposure to blood, body fluid or tissue and as part of their employment, incumbents are not called upon to perform or assist in emergency care or first aid. The incumbent has no occupational risk for exposure to communicable diseases. Because the incumbent works within a healthcare setting, there may be occupational risk for exposure to hazardous medications or hazardous waste within the environment through receipt, transport, storage, preparation, dispensing, administration, cleaning and/or disposal of contaminated waste. The risk level of exposure may increase depending on the essential job duties of the role.
We could put that as a
- for each duty. The responsibilities include a leading sentence plus list. Could put leading sentence in