MINIMUM QUALIFICATIONS:
EDUCATION, CERTIFICATION, AND/OR LICENSURE:
1. High School diploma or equivalent.
EXPERIENCE:
1. Two (2) years’ experience in a healthcare setting.
PREFERRED QUALIFICATIONS:
EDUCATION, CERTIFICATION, AND/OR LICENSURE:
1. Certification in one of the following preferred: CPC (Certified Professional Coder), Certified Professional Coder-Hospital Outpatient (CPC-H), RHIT (Registered Health Information Technician), or Certified Revenue Cycle Representative (CRCR).
EXPERIENCE:
1. Two (2) years’ experience in Patient Financial Services healthcare setting or coding related field.
CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned.
1. Researches and resolves accounts inappropriately reimbursed based on contractual terms in order to enhance reimbursement opportunity with insurance carriers.
2. Prioritizes work in order to effectively reduce volume and meet payer appeal deadlines.
3. Recommends financial revenue, system functionality and other opportunities for improvement based on review of accounts and system workflow such as; contract model usage, modifier usage, epic wq workflow, ANSI code assignment
4. Maintains positive working relationships with internal departments and peers across Health System such as, PFS, Coding, HIM, Accounting, etc.
5. Recognizes and communicates trending payer issues to leader in a timely manner in order for immediate escalation and resolution.
6. Maintains positive working relationships with external vendors such as insurance carriers, government agencies, and insurance provider representatives
7. Advises staff on resolution of patient and/or payer specific issues encountered during review of contract variances as necessary.
8. Maintains competency in functional area assigned through daily work processes, professional development, literature review, seminars, networking, etc.
9. Ensures processes support most efficient manner in order to reduce re-work and multiple touches of accounts.
10. Creates Excel reports based on payer trending issues and monitors for resolution.
11. Runs reports that support unit functions such as registration errors, zero pay, etc.
12. Maintains and researches accounts assigned to Recovery Summary log, IME log and payer projects.
PHYSICAL REQUIREMENTS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
1. Frequent walking, standing, stopping, kneeling, reaching, pushing, lifting, grasping and feeling are necessary body movements utilized in performing duties through the work shift.
2. Must be able to sit for extended periods of time.
3. Visual acuity must be within normal range.
4. Must have manual dexterity to operate keyboards, fax machine, telephone and other business machines.
WORKING ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
1. Normal office environment
SKILLS AND ABILITIES:
1. Good communication skills are necessary to interact effectively with management, staff and external customers.
2. Working knowledge of CPT/ICD-10 coding and regulatory compliance guidelines preferred.
3. Experience in Revenue Cycle/Patient Financial Services preferred.
4. Knowledge of personal computers and Microsoft Excel preferred.
5. Must have reading and comprehension ability.
6. Familiarity with medical terminology preferred.
7. Maintains current knowledge of third party reimbursement regulations in order to enhance ability to recognize issues and react in most appropriate manner.
8. Ability to understand written and oral communication.
9.Ability to multitask and keep numerous ongoing issues organized to effectively impact workflow.
Additional Job Description:
Scheduled Weekly Hours:
40Shift:
Exempt/Non-Exempt:
United States of America (Non-Exempt)Company:
WVUH West Virginia University HospitalsCost Center:
655 SYSTEM Contract ManagementGo Premium: Access the World's Largest Selection of Remote Jobs!