Hours/Days: M-F, 8 am to 5 pm. Position is hybrid.

Key Functions

Manages the processing of commercial claims through account resolution.

* Work with third party carriers to obtain eligibility and out of pocket expenses.

* Monitors claim status via telephone, internet, and/or fax.

* Review and interpret contractual terms and explanation of benefits.

* Identify and post contractual adjustments, third party payments, and out of pocket remittances.

* Set up, maintain, and edit payment arrangements on patient accounts, as necessary.

* Monitor and resolve delinquent accounts through the organization's collections process.

* Processes credit balances and overpayments.

Maintains knowledge of information and functionality.

* Observes all HIPAA required practices including, but not limited to, maintaining HIPAA compliance and confidentiality for all patient and clinic information.

* Maintains knowledge of computer system functions as it pertains to Patient Accounts.

* Enters patient demographics, insurance information, charges, and adjustments to Outpatient accounts.

Provides administrative services for patients; assist staff members, as needed.

* Assist Outpatient Administrative positions and functions, as needed.

* Schedule patient appointments for Outpatient visits.

* Assist clinicians with proper CPT coding selections.

Assist with other Revenue Cycle projects and other duties as requested.

* Accepts additional assignments willingly.

* Demonstrates an ability to respond to changing workloads.

* Assists Utilization Review with initial authorizations and concurrent reviews.

EDUCATION Required: High school diploma or equivalent required. Associates degree in business or related field preferred.

License/Certification

Medical Billing certificate, CRCR, CRCS, CHAA PREFERRED

Experience Required: Two years of Revenue Cycle and hospital experience. Knowledge of Microsoft Office, including Word, Excel, and Outlook.