Job details
Job type full-time
Full job description
Here at savista, we enable our clients to navigate the biggest challenges in healthcare: quality clinical care with positive patient experiences and optimal financial resultsWe partner with healthcare organizations to problem solve and deliver revenue cycle improvement services that enable their success, support their patients, and nurture their communities, all while living our values of commitment, authenticity, respect and excellence (care).
Essential duties & responsibilities:
Utilize various hospital/physician systems to verify patient, billing and claim information for accuracy
Perform compliant primary/secondary, tertiary and rebill billing functions which can include electronic, paper and portal submission to payers.
Edit claims to meet and satisfy billing compliance guidelines for electronic and hardcopy submission.
Respond timely to emails and telephone messages as appropriate.
Communicate issues to management, including payer, system or escalated account issues.
Participate and attend meetings as requested, training seminars and in-services to develop job knowledge.
Serves and protects the hospital community by adhering to professional standards, hospital policies and procedures, federal, state, and local requirements, and jcaho standards.
Enhances billing department and hospital reputation by accepting ownership for accomplishing new and different requests; exploring opportunities to add value to job accomplishments.
Update patient demographics/insurance information in appropriate systems -
Monitor claims for missing information, authorization and control numbers(icn//dcn)
Follows guidelines for prioritization, timely filing deadlines, and notation protocols within appropriate systems
Secure needed medical documentation required or requested by third party insurance carriers
Maintain and respect the confidentiality of patient information in accordance with insurance collection guidelines and corporate policy and procedure
Perform other related duties as required
Minimum requirements & competencies:
High school diploma or ged
At least one year of experience in healthcare insurance billing, working with or for a hospital/hospital system, working directly with government or commercial payers.
Experience identifying billing errors and resubmitting claims as well as following up on payment errors, low reimbursement and denials.
Experiences reading and utilizing eob, 1500 and ub-o4 forms
Knowledge of cd-10, cpt, hcpcs and ncc
Knowledge and ability to utilize third-party billing guidelines
A minimum of 6 months experience of billing claim forms (ub04/1500)
Understanding payor contracts and the ability to read and interpret them.
Basic working knowledge of health information systems (i.eEmr, claim scrubbers, patient accounting systems, etc.)
Knowledge of accounts receivable practices, medical business office procedures, coordination of benefit rules and denial overturns and third-party payer billing and reimbursement procedures and practices.
Demonstrated ability to navigate internet explorer and microsoft office, including the ability to input and sort data in microsoft excel and use company email and calendar tools.
Demonstrated success working both individually and in a team environment.
Demonstrated experience communicating effectively with payers, understanding complex information and accurately documenting the encounter.
Demonstrated ability to meet performance objectives.
Preferred requirements & competencies:
Working knowledge of one or more of the following patient accounting systems - epic, cerner, star, meditech, cpsi, invision, pbar, all scripts or paragon
Working knowledge of dde medicare claim system
Knowledge of government rules and regulations
Core values and culture expectations
Demonstrates integrity and ethics in day-to-day tasks and decision making, adheres to nthrive’s core values of courage, authenticity, respect, excellence and service, operates effectively in the nthrive environment and the environment of the work group, maintains a focus on self-development and seeks out continuous feedback and learning opportunities.
Travel: minimal
Physical demands:
The physical demands and work environment characteristics described here are representative of those that an employee must meet to successfully perform the essential functions of this jobReasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is occasionally required to move around the work area; sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear.
The employee must occasionally lift and/or move up to 15 pounds.
Must be able to talk, listen and speak clearly on telephone.
Mental demands: the employee must be able to follow directions, to get along with others, and handle stress;
Work environment: the noise level in the work environment is usually minimal.
Ability to safely and successfully perform the essential job functions consistent with the ada, fmla and other federal, state and local standards, including meeting qualitative and/or quantitative productivity standards.
Ability to maintain regular, punctual attendance consistent with the ada, fmla and other federal, state and local standards.
Come work for a certified great place to work 4 years in a row!
Savista is an equal opportunity employer and does not discriminate against any employee or applicant for employment because of race, color, age, veteran status, disability, national origin, sex, sexual orientation, religion, gender identity or any other federal, state or local protected class.
