Sr A/R Specialist

About the role

We are more than a health system. We believe wellness and sickness are both part of a lifelong partnership, and that everyone could use an expert guide. We work hard, care deeply and reach further to help people uncover their own power to be healthy. We inspire hope. We learn, grow, and achieve more – in our careers and in our communities. This position is for a Revenue Integrity Payment Variance Specialist. The person for this position would need to have a strong background in how insurance companies work, how the contracts are designed, written and maintained and have a very keen eye for spotting payment variances amongst all of our contracted insurance companies. Department: Corporate Revenue Integrity. Join us! if your passion is to work in a caring environment if you believe that learning is a life-long process if you strive for excellence and want to be among the best in the healthcare industry.

Responsibilities

• Maintains accounts receivable balance and follows up on collection of accounts (30%):
  • Reconciles cash receipts/cash posting
  • Updates appropriate records as payments are received
  • Maintains accounts receivable, does follow-up with payors on regular and on-going basis
  • Balance bills secondary insurance and patients/families
  • Works with medical records to ensure complete/accurate charts for billing compliance
  • Reports denials and billing problems to Account Receivable Supervisor
  • Prepares recertification reports
• Verifies insurance information to ensure accurate and timely billing of all patient revenue, negotiation of per diem payment with commercial payors and timely billing of all patient revenue (30%):
  • Assists patients/families and staff in completion of all paperwork to obtain eligibility
  • Verifies primary and secondary payors for each patient from admission paperwork
  • Verifies coverage for all commercial insurance prior to admission, negotiating payment with assistance from Accounts Receivable Supervisor as appropriate
  • Documents all pertinent information in the patient billing file and maintains file
  • Works with patients/families to advise of potential financial responsibility
  • Notifies payors of patient elections and discharges as appropriate
• Coordination of third party and patient billing (20%):
  • Prepares billing forms and required documentation and completes billing of all services to the appropriate payors
• May assume job duties of the AR Supervisor and/or co-worker's in their absence (10%):
  • Responsible for training new staff and cross training of other staff on responsibilities
• Performs other miscellaneous duties which includes, but is not limited to (10%):
  • Collecting data and preparing reports
  • Maintaining all paper and computer files relative to the area
  • Participate in staff meetings, support activities, and in-services and retreats to nurture personal and professional growth
• As a High Reliability Organization (HRO), responsibilities require focus on safety, quality and efficiency in performing job duties.

Requirements

• High School or GED (required)
• Good understanding of medical coding
• Working knowledge of medical terminology
• Ability to work as part of a team with attention to detail and balanced concern for both accuracy and efficiency

Schedule

Day shift, 40 hours per week.