Under general supervision by the department's Manager of Governmental Billing and Reimbursement, this position is responsible for the accuracy and integrity of the accounts receivable for all AHS sites. This position also provides communication regarding reimbursement issues or trends from Governmental payers, along with providing education to team members, training in collaboration with the Supervisor and follow as necessary for proper reimbursement.
Job Responsibilities
- Analyze hospital claim and reimbursement data to identify contractual underpayments or billing errors.
- Pursue underpayments with insurance provider representatives via monthly teleconference to effectively resolve complicated accounts where AHS is not in agreement with ow the carrier processed the accounts
- Provide management payor reports to identify trending contractual issues
- Compile queries and complex data sets to analyze payor reimbursement using EPIC reporting tools
- Reviewing contracts for accurate payments and identifying payor trend issue with payment or codes.
- Thorough knowledge and understanding of regulatory and insurance requirements
- Performs other duties as assigned
Required
- Associate or bachelor’s degree in accounting, business or related field.
- 3-5 years’ experience working in Hospital Biling for Medicare/Medicaid or relevant area
- Experience in conducting analysis of third-party reporting.
- Must be proficient in Word, Excel, and other Microsoft office applications.
- Must have excellent communication skills; must be able to articulate in a clear and concise manner orally and in written form
Preferred
Experience with Hospital Cost Reporting.
Experience and knowledge of Clinic Reimbursement rules and practices.
Job description provided by Atlantic Health System.
View the original posting
