What are the responsibilities and job description for the Denials Analysis Clerk - Full Time position at Gibson Area Hospital?
GENERAL SUMMARY
To assist, investigate and correct denied claims of Medicare, Medicaid, Commercial Insurance and Private pay accounts receivable. There will be phone and email interaction with Third Party Payers, family members and patients whom we are needing to obtain correct and up to date insurance information in order to resubmit denied claims.
GIBSON AREA HOSPITAL & HEALTH SERVICES MISSION STATEMENT
To provide personalized, professional healthcare services to the residents of the communities we serve.
PRINICIPAL DUTIES AND RESPONSIBILITIES
1. Daily chart auditing recorded in excel sheets
2. Monthly denial reports worked then sent to clinics for review.
3. Prepare training material in relation to denied claims to ensure reduction of denied claims.
4. Work denials from beginning to end including rebills when necessary.
5. Additional duties assigned by Clinical Denials Manager.
REPORTING RELATIONSHIP
Reports to Clinical Denials Manager
EDUCATION, KNOWLEDGE, AND ABILITIES REQUIRED:
1. High school graduate or equivalent.
2. Ability to deal with the public in a pleasing and efficient manner.
3. Skill with computer application and other office equipment
4. Ability to speak clearly and concisely
5. General knowledge of mathematics and accounting principals
6. Ability to establish and maintain effective working relationships with patients, employees, and the public
7. Good communication skills to obtain patients missing information in order to bill claims.
8. Requires analytical skills to evaluate claims for errors in billing and payment from payers.
9. Knowledge of Patient Rights.
10. All other duties as assigned by the Clinical Denial Manager.
PHYSICAL REQUIREMENT
Physical strength to perform the following lifting tasks:
Floor to waist - 20 pounds
14 to waist - 30 pounds
Waist to shoulder - 10 pounds
Shoulder to overhead - 10 pounds
Carry 20 pounds for 30 feet
Push 10 pounds/force for 15 feet
Pull 10 pounds/force for 15 feet
INFECTION EXPOSURE RISK LEVEL
Category 3 No Risk Your job does not involve exposure to blood, body fluids or tissue. You do not perform or help in emergency medical care or first aid as part of your job.
WORKING CONDITIONS
1. Will work in an office with co-workers where traffic may be constant subjecting your work to interruptions, which can produce stress and fatigue.
2. Involves frequent contact with staff, patients and the public and may involve dealing with angry or upset people.
3. Works with an office where there are relatively few discomforts due to dust or dirt. There is some exposure to print noise.
4. May be required to work beyond regular office hours.
To assist, investigate and correct denied claims of Medicare, Medicaid, Commercial Insurance and Private pay accounts receivable. There will be phone and email interaction with Third Party Payers, family members and patients whom we are needing to obtain correct and up to date insurance information in order to resubmit denied claims.
GIBSON AREA HOSPITAL & HEALTH SERVICES MISSION STATEMENT
To provide personalized, professional healthcare services to the residents of the communities we serve.
PRINICIPAL DUTIES AND RESPONSIBILITIES
1. Daily chart auditing recorded in excel sheets
2. Monthly denial reports worked then sent to clinics for review.
3. Prepare training material in relation to denied claims to ensure reduction of denied claims.
4. Work denials from beginning to end including rebills when necessary.
5. Additional duties assigned by Clinical Denials Manager.
REPORTING RELATIONSHIP
Reports to Clinical Denials Manager
EDUCATION, KNOWLEDGE, AND ABILITIES REQUIRED:
1. High school graduate or equivalent.
2. Ability to deal with the public in a pleasing and efficient manner.
3. Skill with computer application and other office equipment
4. Ability to speak clearly and concisely
5. General knowledge of mathematics and accounting principals
6. Ability to establish and maintain effective working relationships with patients, employees, and the public
7. Good communication skills to obtain patients missing information in order to bill claims.
8. Requires analytical skills to evaluate claims for errors in billing and payment from payers.
9. Knowledge of Patient Rights.
10. All other duties as assigned by the Clinical Denial Manager.
PHYSICAL REQUIREMENT
Physical strength to perform the following lifting tasks:
Floor to waist - 20 pounds
14 to waist - 30 pounds
Waist to shoulder - 10 pounds
Shoulder to overhead - 10 pounds
Carry 20 pounds for 30 feet
Push 10 pounds/force for 15 feet
Pull 10 pounds/force for 15 feet
INFECTION EXPOSURE RISK LEVEL
Category 3 No Risk Your job does not involve exposure to blood, body fluids or tissue. You do not perform or help in emergency medical care or first aid as part of your job.
WORKING CONDITIONS
1. Will work in an office with co-workers where traffic may be constant subjecting your work to interruptions, which can produce stress and fatigue.
2. Involves frequent contact with staff, patients and the public and may involve dealing with angry or upset people.
3. Works with an office where there are relatively few discomforts due to dust or dirt. There is some exposure to print noise.
4. May be required to work beyond regular office hours.
