Duties : Job Summary :

• Under general supervision by the department's Supervisor, Team Lead, and Manager of Reconciliation and Reimbursement, this position is responsible for the accuracy and integrity of all monies received to AHS.
• Obtain status on Non-Governmental outstanding accounts receivable, EOBs and follow up with insurance payors on claims.
• Reviewing contracts for accurate payments and identifying payor trend issues with payment or codes.
• Notate all accounts with outcome / resolution and / or next steps.
• Working denials, submitting appeals, and correcting claims.
• Cash Posting.
• Insurance refund processing.
• Extensive insurance follow-up for various insurance plans.
• Ensure insurance information is entered on accounts accurately regarding primary, secondary and tertiary coverage that is received from patients.
• Performs all other duties as required by the supervisor / manager.
• Must maintain up-to-date knowledge of departmental policies and procedures by attending department meetings and trainings (online and classroom).

Skills :

Required Skills & Experience :

• Minimum of 1 years' experience in Healthcare Operations.
• Strong negotiation, collection, and phone skills.
• Excellent communication skills; must be able to articulate in a clear and concise manner.
• Demonstrates computer keyboard, word processing, spreadsheet skills, and multiple system skills enough to meet job criteria and goals.
• Demonstrates ability to perform data entry and clear communication to multiple levels of the organization.
• Planning and organizational skills that give the candidate the ability to multi-task, prioritize work, support and accept direction for multiple sources, and perform detailed tasks with efficiency and accuracy.
• Ability to understand insurance terms, (i.e. HMO, PPO, EOB, Remit, Stop Loss, etc).
• Strong data and organization skills.
• Thorough knowledge and understanding of insurance plan policy updates including authorization and medical necessity requirements.
• Overall awareness of specific insurance plans accounts receivable issues.

N / A

Keywords : Education :

Education : Required Education :

Required Education :

High School Diploma, GED, or equivalent.

Preferred Education :

• Associate's Degree or Bachelor's Degree from an accredited College or University.

Last updated : 2024-07-02