Job Type: Full Time
Posted an hour ago
Apply Now
Description
Job Description
Summary:
Responsible for the duties and services that are of a support nature to the RCBS High Performance Work Teams. Ensures that all processes are performed in a timely and efficient manner. Performs assigned duties such as, cash posting, customer service, data entry and reviewing of claims for proper billing/collections. Responsible for performing billing, collections and reimbursement services of claims and duties to hospitals supported by the RCBS. In doing so, ensures that all claims billed and collected meets all government mandated procedures for Integrity and Compliance. Performs billing, collections and reimbursement services in a prompt and efficient manner. Provides thorough, courteous and professional assistance to patients, physician offices, insurance companies and other clients on an as needed basis while maintaining strictest confidence. Documents, forwards, resolves incoming mail and correspondence. Demonstrates a level of accountability to ensure data and codes are not changed on claims prior to submission if related to diagnosis, charge and/or other clinical type data that RCBS would not have knowledge of. Ensures all Compliance errors are reported to the Director and maintain records and files of documentation supporting bill changes that are directed by Director and/or Integrity Officer. Responsible to ensure successful implementation of Governmental Regulatory Billing changes, including but not limited to Medicare OPPS effective August 1, 2000.
Responsibilities:
Ensures daily productivity standards are met and daily EOB'S, reports and appeal files are cleared with in 48 hours of receipt (allowing for weekends and holidays)
Log IPOs as issues arise and report during shift briefing Maintains an active working knowledge of all Governmental Mandated Regulations as it pertains to claims submission
Responsible to perform the necessary research in order to determine proper governmental requirements prior to claims submission
Responsible to contact Clinical departments and Medical Records in order to obtain information relevant to erred claims as possible Integrity issues
Works with Departments for proper resolution of erred claims
Maintains logs of Integrity related governmental claims and reports to Management weekly
Reviews and resolves claims that are suspended daily in electronic billing terminals in accordance with procedure
Responsible for working claims generated reports, providing proper documentation and making necessary corrections within specified times
Ensures quality standards are met and proper documentation regarding patient accounting records Reviews and resolves claims that are suspended daily in electronic billing files in accordance with procedure Ensures all correspondence, rejected claims and returned mail is worked within 48 hours of receipt (allowing for weekends and holidays)
Ensures business service requests are worked and documented within 24 hours of receipt
Identifies and forwards proper account denial information to the designated departmental liaison
Dedicates efforts to ensure a proper denial resolution and timely turnaround
Monitors and communicates errors generated by other departments, communicating trends Maintains an active working knowledge of all billing and reimbursement requirements by Payer
Continuously receives updates and information regarding changes and newly revised billing and reimbursement practices and ensures compliance
Stays abreast of all government changes
Provides continuous updates and information to Business Office Management regarding ongoing errors, payer related issues, registration issues and other controllable QA related activities affecting reimbursement and payment methodology
Requirements:
HS Diploma or equivalency required
Post HS education preferred
Work Type:
Full Time
EEO is the law - click below for more information:
We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact us at .
Req. No
190530
Job Title
Patient Financial Specialist - Spohn Medical Offices
Market
CHRISTUS Spohn
Category
Revenue Cycle
Facility
CHRISTUS Spohn Medical Offices Saratoga Blvd
Address
5802 Saratoga Blvd
Corpus Christi, TX 78414
US
Type
FULL TIME
Summary:
Responsible for the duties and services that are of a support nature to the RCBS High Performance Work Teams. Ensures that all processes are performed in a timely and efficient manner. Performs assigned duties such as, cash posting, customer service, data entry and reviewing of claims for proper billing/collections. Responsible for performing billing, collections and reimbursement services of claims and duties to hospitals supported by the RCBS. In doing so, ensures that all claims billed and collected meets all government mandated procedures for Integrity and Compliance. Performs billing, collections and reimbursement services in a prompt and efficient manner. Provides thorough, courteous and professional assistance to patients, physician offices, insurance companies and other clients on an as needed basis while maintaining strictest confidence. Documents, forwards, resolves incoming mail and correspondence. Demonstrates a level of accountability to ensure data and codes are not changed on claims prior to submission if related to diagnosis, charge and/or other clinical type data that RCBS would not have knowledge of. Ensures all Compliance errors are reported to the Director and maintain records and files of documentation supporting bill changes that are directed by Director and/or Integrity Officer. Responsible to ensure successful implementation of Governmental Regulatory Billing changes, including but not limited to Medicare OPPS effective August 1, 2000.
Responsibilities:
Ensures daily productivity standards are met and daily EOB'S, reports and appeal files are cleared with in 48 hours of receipt (allowing for weekends and holidays)
Log IPOs as issues arise and report during shift briefing Maintains an active working knowledge of all Governmental Mandated Regulations as it pertains to claims submission
Responsible to perform the necessary research in order to determine proper governmental requirements prior to claims submission
Responsible to contact Clinical departments and Medical Records in order to obtain information relevant to erred claims as possible Integrity issues
Works with Departments for proper resolution of erred claims
Maintains logs of Integrity related governmental claims and reports to Management weekly
Reviews and resolves claims that are suspended daily in electronic billing terminals in accordance with procedure
Responsible for working claims generated reports, providing proper documentation and making necessary corrections within specified times
Ensures quality standards are met and proper documentation regarding patient accounting records Reviews and resolves claims that are suspended daily in electronic billing files in accordance with procedure Ensures all correspondence, rejected claims and returned mail is worked within 48 hours of receipt (allowing for weekends and holidays)
Ensures business service requests are worked and documented within 24 hours of receipt
Identifies and forwards proper account denial information to the designated departmental liaison
Dedicates efforts to ensure a proper denial resolution and timely turnaround
Monitors and communicates errors generated by other departments, communicating trends Maintains an active working knowledge of all billing and reimbursement requirements by Payer
Continuously receives updates and information regarding changes and newly revised billing and reimbursement practices and ensures compliance
Stays abreast of all government changes
Provides continuous updates and information to Business Office Management regarding ongoing errors, payer related issues, registration issues and other controllable QA related activities affecting reimbursement and payment methodology
Requirements:
HS Diploma or equivalency required
Post HS education preferred
Work Type:
Full Time
EEO is the law - click below for more information:
We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact us at .
Req. No
190530
Job Title
Patient Financial Specialist - Spohn Medical Offices
Market
CHRISTUS Spohn
Category
Revenue Cycle
Facility
CHRISTUS Spohn Medical Offices Saratoga Blvd
Address
5802 Saratoga Blvd
Corpus Christi, TX 78414
US
Type
FULL TIME
