Position Summary / Career Interest:

Responsible for accurate and timely action on accounts as it relates to specific responsibilities. Complies with governmental and managed care rules and regulations. Meet department goals as well as productivity and quality standards. Attends and actively participates in training and education. Responsible for functions within assigned Patient Financial Services (PFS) department. PFS departments/teams include: - Payment Posting/Credits & Refunds - Insurance follow up - Provider Enrollment - Revenue Integrity

Responsibilities and Essential Job Functions

• Posts payments, refunds and adjustments to accounts within designated time frame.
• Completes assigned work queue within designated time frame.
• Balances receipts, reconciles daily batches and prepares audit trail in accordance to department guidelines.
• Reviews Explanation of Benefit’s for incorrect and or inconsistencies in reimbursement.
• Identifies consistent fee schedule allowable differences and communicates up line for updating.
• Communicates payer trends to management.
• Follows up with insurance companies on denials and insurance inquiries as necessary to resolve the account.
• Provides additional information or documentation as needed to resolve account.
• Notes actions taken on the accounts and verifies and updates insurance as directed by department policy.
• Completes assigned work queue within designated time frame.
• Processes adjustments on accounts as necessary in compliance with department policy.
• Enrolls, validates and re-validates practitioners’ information with government and commercial payers.
• Updates databases, monitors Medicare, Medicare and Commercial payer websites for revalidation notices and communicates provider changes to contracted health plans and departments utilizing standardized reports.
• Assists with processing applications in accordance to organization's policy, procedures and health plan requirements.
• Audits provider data to assure accuracy as assigned.
• Communicates roster changes from physician groups.
• Review department specific Epic Charge work queues, make corrections and follow up with departments as needed.
• Review daily Epic charge router reconciliation report make sure all charges are filed and interfaced.
• Assist departments with charge error corrections including duplicate, missing or rejected charges.
• Analyze revenue trending reports and escalate problems to manager and departments as appropriate.
• Must be able to perform the professional, clinical and or technical competencies of the assigned unit or department.
• These statements are intended to describe the essential functions of the job and are not intended to be an exhaustive list of all responsibilities. Skills and duties may vary dependent upon your department or unit. Other duties may be assigned as required.

Required Education and Experience

• High School Graduate or GED.

Preferred Education and Experience

• 1 or more years of experience in Epic.

We are an equal employment opportunity employer without regard to a person’s race, color, religion, sex (including pregnancy, gender identity and sexual orientation), national origin, ancestry, age (40 or older), disability, veteran status or genetic information.