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Today, SCA Health has grown to 11,000 teammates who care for 1 million patients each year and support physician specialists holistically in many aspects of patient care. Together, our teammates create value in specialty care by aligning physicians, health plans and health systems around a common goal: delivering on the quadruple aim of high-quality outcomes and a better experience for patients and providers, all at a lower total cost of care.
As part of Optum, we participate in an integrated care delivery system that enables us to support our partners as they navigate a complex healthcare environment, Only SCA Health has a dynamic group of physician-driven, specialty care businesses that allows us to customize solutions, no matter the need or challenge:
The new SCA Health represents who we are today and where we are goingand the growing career opportunities for YOU.
Accountabilities / Responsibilities:A. | JOB KNOWLEDGE |
1. | Demonstrates knowledge and ability to bill/re-bill all claims received on a daily basis; notifies Billing Office Manager of any claims received which cannot be billed on date received. |
2. | Maintains current working knowledge of third-party billing requirements. |
3. | Maintains general current working knowledge of ICD and CPT coding. |
4. | Maintains current working knowledge of the current coverage allowances for assigned payor class. |
5. | Demonstrates a working knowledge of procedures to process claims. |
6. | Demonstrates the knowledge to complete productivity. |
7. | Knows of third-party billing requirements |
8. | Knows of ICD and CPT coding |
Cognitive/Critical Thinking Skills Required | |
9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. | Uses judgment and problem solving to provide patient assistance in reconciling account balances appropriately. Performs independent problem solving Makes decisions logically and deliberately Performs actions that demonstrate accountability Exercises safe judgment in decision making Practices within legal and ethical guidelines Uses a series of sequential, interdependent decisions concerning the stages in billing and follow-up of assigned patient accounts Sets sound priorities for sequencing and completing activities Is consistently aware of patient safety Knows how to seek resources for direction, when necessary Seeks resources for direction, when necessary |
B. | PRODUCTIVITY |
1. | Ensures accurate and timely billing/re-billing of primary, secondary and tertiary insurance for assigned section of the alphabet within designated payor class. |
2. | Maintains proper attendance and punctuality in accordance with hospital policy. *a. Attends work as scheduled. *b. Becomes knowledgeable of established productivity goals and strives to surpass the minimum acceptable goals in his/her daily performance. *c. Performs timely billing of accounts upon completion of coding from Medical Records (B6). *d. Works systematically and prioritizes tasks. *e. Demonstrates initiative in completing job responsibilities. *f. Performs thorough follow-up of unpaid balances. |
3. | Follows up on unpaid balances with insurance companies. (Thorough follow-up includes timely processing of referred accounts through remittances, ledgers audit trails, outstanding claims report, telephone and/or written inquiries). *a. Processes adjustments and/or re-bills accounts. *b. Completes and thoroughly processes remits within one week from date of receipt (to include the re-billing of necessary accounts) *c. Processes audit trail reports and re-bills, if necessary, all accounts within one week from date of receipt. *d. Maintains quantity and quality follow-up on a minimum of 70% of accounts needing follow-up. |
4. | Demonstrates knowledge and ability to bill/re-bill all claims received on a daily basis. Notifies Patient Accounts Coordinator of any claims received which cannot be billed on the date received. *a. Maintains current working knowledge of third-party billing requirements. *b. Maintains general current working knowledge of ICD and CPT coding. *c. Maintains current working knowledge of the current coverage allowances for assigned payor class. |
Full Time
$38k-47k (estimate)
06/29/2024
07/18/2024