Lead Insurance Claims Representative PFS -- PATIENT FINANCIAL SERVICES -- Hartman Run Road

Job Summary

With a patient centered culture, the Insurance Claims Specialist provides a positive experience for our patients andcustomers by managing the patient accounts during pre and post claims processing. This management includes accurateclaim submission with payee guidelines, timely accounts, follow- up and assistance with denial management issues toensure the financial viability of Mon Health.

Responsibilities

Integrity
Identifying what needs to be done and doing it before being asked or before the situation requires it. Openness todifferent and new ways of doing things; willingness to modify one's preferred way of doing things.

Commitment
The ability to demonstrate concern for satisfying one's external and/or internal customers.

Accountability
The ability to ensure that information is passed on to others who should be kept informed.

Respect
As a team member, the ability and desire to work cooperatively with others on team; develop, maintain and strengthenpartnerships with others inside or outside the organization who can provide information, assistance and support.

Excellence
Ensuring that one's own and others' work and information are complete and accurate; carefully preparing for meetingsand presentations; following up with others to ensure that agreements and commitments have been fulfilled.

Account Management
Maintains knowledge of revenue cycles operations, third-party reimbursement by local/state/federal payers.

Customer Service
Ensures that patients, family members and customers are given exceptional service during their patient registrationprocess. Takes actions to resolve patient conflicts in a manner that is best for the organization and the individual(s)involved. Speaks in a clear and concise manner, selects the right tone and displays appropriate body language for thesituation and audience while demonstrating active listening skills. Demonstrates an awareness of, and sensitivity to, theneeds and concerns of individuals from different cultures.

Quality/Accuracy
Applies all codes according to established coding guidelines with an accuracy rate as determined and established bydepartment policy or guidelines.

Time Management
Meets productivity standards that have been established for the position and/or department. Prioritizes multiple tasks.Completes assignments per protocol or as directed. Embraces new and innovative approaches that will improveefficiency.

Understanding Roles and Responsibilities
Takes responsibility for clarifying job responsibilities, including the need to understand performance standards and otherexpectations. Communicates with supervisor regularly to ensure that there is no misunderstanding about howperformance will be measured and how expectations relate to the job. Seeks clarification as needed or whenresponsibilities are not understood. Willingly accepts change.

Knowledge, Skills & Abilities

Light Work: Exerting up to 20 lbs. of force occasionally and/or up to 10 lbs. frequently and/or negligible amounts constantly.

One (1) year experience in healthcare billing/revenue cycle patient accounting OR a graduate of a medical billing/codingor medical office program required. Knowledge of patient billing practices, medical terminology, patient registration, andfederal, state and third-party billing regulations preferred.

Education

• High School Diploma or GED (Required)

Credentials

Work Schedule: Days

Status: Full Time Regular 1.0

Location: Hartman Run Road

Location of Job: WV:Morgantown:Mon Medical Center

Talent Acquisition Specialist: Guy S. Stewart guy.stewart@vandaliahealth.org