Job Details

Responsible for helping coordinate the billing, cash posting, and collection of outstanding accounts in the Business Office. Provides assistance and backup for the Revenue Cycle Director.

Responsibilities

• Prepare billing files to send electronically, checking for accuracy. Document accounts. Verify files were received by SSI. Keep applicable spreadsheets with totals.
• Prepare hard copy claims to send daily, checking for accuracy. Document accounts.
• Work on the Process Rejection Batch routine and correct errors.
• Print and work the Late Charges report.
• Compile and upload Bad Debt files to collection agency.
• Compile and upload Patient Statement files to third?party vendors.
• Compile credit balance report, verify refunds for accuracy, and process refund list. Submit it to the director for review and approval. Final approval by CFO.
• Check each assigned payers remittances against the systems expected reimbursement. Research variances and appeal remittance if necessary. Report trends or issues to the Revenue Cycle Director.
• Work aggressively to reduce AR by following up on denials, underpayments, and overpayments.
• Collaborate with the Reimbursement Specialist to appeal underpayments and denials.
• Resolve claims denied due to no authorization, incorrect codes, improper billing, etc.
• Review accounts for further collection, including phone calls, letters, final notices, and collection agency representation.
• Work closely with the Director on accounts that need to be assigned to agency and/or suits, including seeking additional approval (if required), documenting accounts, and following next steps.
• Stay current on updates or changes to the computer system, other software programs, laws, or continuing education concerning billing or account collection.
• Sort, respond to, document, and file correspondence.
• Help resolve problems, answer inquiries, and liaise with internal and external customers on patient account issues.
• Provide backup for other positions in the department.
• Make recommendations to the Director on ways to improve efficiencies or processes for the department.
• Handle special projects as assigned by management or other duties as assigned.
• As an employee of SHOLA, ensure compliance with all federal and state privacy protection laws and regulations (HIPAA). Recognize protected health information (PHI) that requires protection, determine permissible access, use, or disclosure of PHI, and reduce risk of impermissible use.
• Provide exceptional patient satisfaction in all encounters with patients, families, and visitors. Hold yourself and peers accountable for outstanding patient satisfaction.

General Duty Statement

The statements above outline the general duties necessary to describe the essential functions of this position. They are not a comprehensive description of all work requirements that may be inherent in the position.

Qualifications

Education: High school diploma or equivalent required; college degree in a business?related field preferred.

Experience: At least three (3) years in a medical business office environment performing billing, payment posting, follow?up, and collections preferred.

Licenses/Certificates: None.

Special Skills: Knowledge of complete revenue cycle processes, including billing government programs such as Medicare and Medicaid, commercial payers, and other third parties; reimbursement from all payers; contract evaluation for proper payment adjudication and patient responsibility; denial management. Must know medical terms, CPT/HCPCS codes, ICD?10 codes, etc. Excellent communication skills, including written, spoken, and listening skills, essential. Must be a team player, able to teach skills to others, possess excellent interpersonal and organizational skills, work positively and professionally, and have good time?management, problem?solving, and critical?thinking skills. Proficient in Excel and Word. Knowledge of Meditech, SSI, Passport, and other related systems is a plus. Ability to understand and apply state and federal healthcare billing laws and regulations.

Reports To: Revenue Cycle Director

Positions Reporting Directly: None

Seniority Level: Mid?Senior level

Employment Type: Full?time

Job Function: Accounting/Auditing and Finance

Industry: Hospitals and Health Care

Location: Baton Rouge, LA

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