JOB SUMMARY AND SCOPE
To seek reimbursement for hospital patient accounts by accurately billing third party payors and patients, and performing follow-up as necessary to secure payment for each patient account.
ESSENTIAL JOB FUNCTIONS
- Reviews bills daily as they are printed and edits bills as necessary in preparation for submission to third party payors
- Reviews daily rejections from third party payors and re-submits within 5 business days.
- Contacts third party payors to seek information and to solve problems that arise during the reimbursement process
- Meets with patients to solve problems with patient accounts
- Reviews a monthly aged trial balance in order to prevent accounts from aging past filing limits and takes corrective action
- Manage assigned accounts to an average of 50-60 days in AR, or as assigned.
- Keeps abreast of new laws, compliance and changes in third party billing process
- Reviews various reports for overpayments, late posted charges, incorrectly posted charges and payments, and takes corrective action, being mindful of applicable filing limits.
- Processes credit balances due to overpayments in accordance with hospital policy
- Works with appropriate hospital departments to coordinate the reimbursement process
- Accepts cash payments and prepares receipts
- Processes hospital mail
- Seeks out needed information by staying informed and involved by attending meetings, reading memos, policies, meeting minutes, newsletters, email and other appropriate information in a timely manner.
- Reliable attendance and punctuality, including observing appropriate break times and extending a a
- Performs duties in a safe manner, in compliance with all safety policies and procedures
- Complies with the Code of Conduct and all appropriate policies and procedures
- Other duties, as assigned, that are relevant to the position and department
Requirements
MINIMUM REQUIREMENTS
- Associates Degree in Business or two years related experience
PHYSICAL EFFORT AND ENVIRONMENT
Moderate: Occasionally lifts up to 25 pounds independently. Occasionally pushes/pulls 100 pounds. Stands or walks often.
EXPOSURE RISK
Exposure Category III: Employee not reasonably expected to be at risk for exposure to blood borne pathogens.
QUALITY IMPROVEMENT
- Maintains current knowledge of the hospital-wide Quality Improvement Program.
- Collaborates with management to improve the effectiveness of the department through the Quality Improvement plans and processes.
- Participates in the departmental and hospital-wide Quality Improvement activities as directed by the manager.
COMPLIANCE
- Adheres to the federal, state, and local statutes and regulations.
- Adheres to the Compliance Program policies and procedures of Down East Community.
- Adheres to all Privacy and Security policies and procedures of Down East Community.
- Communicates any concern related to compliance issues to manager of department or Compliance Officer.
- Communicates any concern related to confidentiality issues to the Privacy Officer.
*DECH is an equal opportunity employer.