Description

Essential Functions

• Responsible for billing all patient claims in a timely manner

• Responsible for financial assessment of patients, calculation of all TDFPS files, charges and billing, Performs QA of information on admissions, collection of deductibles when needed.

• Assist in batching of deposits.

• Completes all adjustments from TDFPS.

• Process daily day-ends for the hospital, assist in the close of the month, preparations and reporting;

• Calculates deposits for the hospital and works closely with the CFO.

• Performs log requirements for Medicaid patients.

• Assists in the documentation of correspondence.

• Business auditing of charts to assure proper billing and documentation.

• Review claims issues, make corrections as needed, and rebill. Utilize claims clearing house to review and correct claims and to resubmit electronically when available.

• Responsible for printing daily billing reports both electronic and paper claims. Monitor validation percent.

• Work daily claims rejection lists.

• Responsible for posting insurance and patient payments, contractuals, and all other adjustments.

• Review explanation of benefits to ascertain that claim processed and paid correctly. If processed incorrectly provide detail information to collector for follow up.

• Complete adjustment forms if any adjustments need to be made to an account and attach all supporting documentation.

• Maintain daily cash log noting any variances on a daily basis. Gathers and interprets data from the system and understands appropriate course of action to take and initiates time-sensitive and strategic steps resulting in payment.

  Job requirements

• Must have a high school diploma or GED.

• Minimum 5 years of job-related experience; with emphasis on admissions and/or collections experience in a hospital setting required; psychiatric experience preferred.

• Must have strong written and verbal skills; ability to deal effectively with all levels of hospital management and the public.

• Must be able to demonstrate average to high math skills.

• Advanced computer skills including Microsoft Office; especially Word, Excel, and PowerPoint.

• Ability to work professionally with sensitive, proprietary data & information while maintaining confidentiality.

• Excellent interpersonal skills including the ability to interact effectively and professionally with individuals at all levels; both internal and external.

• Exercises sound judgment in responding to inquiries; understands when to route inquiries to next level.

• Self-motivated with strong organizational skills and superior attention to detail.

• Must be able to manage multiple tasks/projects simultaneously within inflexible timeframes. Ability to adapt to frequent priority changes.

• Capable of working within established policies, procedures and practices prescribed by the organization.

Qualifications

Skills

Preferred

• Financial Awareness: Novice

• Negotiating: Novice

• Problem Solving: Novice

Behaviors

Preferred

• Leader: Inspires teammates to follow them

• Detail Oriented: Capable of carrying out a given task with all details necessary to get the task done well

• Dedicated: Devoted to a task or purpose with loyalty or integrity

• Functional Expert: Considered a thought leader on a subject

Motivations

Preferred

• Flexibility: Inspired to perform well when granted the ability to set your own schedule and goals

• Goal Completion: Inspired to perform well by the completion of tasks

• Self-Starter: Inspired to perform without outside help

• Ability to Make an Impact: Inspired to perform well by the ability to contribute to the success of a project or the organization

Education

Required

• High School/GED or better

Experience

Preferred

• insurance verification

• billing experience

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)