Medhost Jobs (NOW HIRING)

PRIMARY DUTIES AND RESPONSIBILITIES(OTHER DUTIES MAY BE ASSIGNED)

• Identifya minimum of 25healthcare insurance underpaymentsfor hospitals'patient accountsper dayvia MEDHOST Contract Management application;identification of varianceunderpaymentswill includezero payments, full denials, line-item denials, billing corrections, updated billing coderequirementsand incorrect payor system setup.MEDHOST Variance & Denial Reports areutilizedtoassistwith identification of variances.

• Verify insurance payment for accuracy and compliance with contract terms and fee schedules.

• Identifyroot cause of insurance reimbursement underpayments and takeappropriate actionsto resolve payment variances;work efforts are to be focusedonidentification and recovery ofhigh dollar insurance underpayments, zero paymentsand trendingto increase reimbursements for the hospital.

• Utilize Contract Management Worklist reporting tofacilitateprompt identification of insurance variances.

• Review claims billed and insurance remits to research variances; claim review may include coding,billing,and discrepancies with patients' insurance information.Collaborate with the facilities to send corrected claims and appeals.Ability to navigate within MEDHOST andcustomer'sclearinghouse systems toidentifyroot causes of variances.

• Notatevariance reason within patient accounts and update patient accountsutilizingpre-defined variance reasoncodesvia MEDHOST system.

• Contactinsurance providersregardingidentified underpayments and follow insurance payor guidelines to collectadditionalreimbursement on behalf of the facility.

• Continue to follow-up with insurance payors once the payor has verified the underpayment and account resolution isdeterminedbased on MEDHOST standard guidelines.

• Work accounts with variancesutilizinga broad range of collection approaches including telephone calls with individual resources, conference calls with a group of resources,presentations, screen sharing,written communication,electronic faxing, uploading information to payor websites,rebilling of claims, etc.

• Notatefollow-up efforts made towards the collection process on the patient accounts viaMEDHOSTsystem.

• Communicate variance identification and recovery updates to clients weekly/monthly.

• Prioritize activities to work variances and denialsin a timely manner.

• Collaborate with the MEDHOST Contract Management Build/Specialist teamregardingcontract build issuesidentifiedduring the underpaymentresearchprocess.

• Review underpayment andoverpaymentfalse variances with client to minimize future false variances.

• Maintain customer meeting agendas andfacilitatecustomer status calls; communication to include variance trendsidentified, weekly/monthlyvariancereporting, contracts & fee schedules needed tomaintainfacility'scontract builds and report information that may hinder Contract Management work.

• RequestassistancefromMEDHOST andfacility's'leadershipregardingunsuccessful attempts to collect underpayments.

• Complete projectsassignedto improve operations within the team and to increase reimbursements for facilities.

• Assist others with projectsand provide trainingto team members and customersasneeded.

• Collaborate withfacilities andother MEDHOST teams for resolution of outstanding items.

• Maintain the effectiveness and implementation of the MEDHOST Quality Management System and meet applicable regulatory requirements as needed.

• Responsible for QMS procedures listed in QMS Procedure Crosswalk found in QMS Manual as applicable.

• Any other duties asdeemednecessary to provide quality service to MEDHOST customer base and CM team.

Wage:

$18-$28/hr

Administrative Duties:

• Accurately input/submitworked time by the required departmental deadlines.

• Maintain MEDHOST software applicationsutilized& industry knowledge through self-study and by attending training classes.

• Maintain in-depth knowledge of insurance payers and collection regulations.

• Attend andparticipatein team and departmental meetings.

• Respond to email, Microsoft Teams,and phone communicationsin a timelymannerand with professionalism.

• Ensure that all HIPAA Privacy and Security requirements and responsibilities are adhered to.

• Access protected health information (PHI)in accordance withdepartmental assignments and guidelines.

• Bookstravel in adherence to the companyand departmenttravel policy.

Knowledge,Skillsand Abilities:

• Knowledge of hospital billing and revenue cycle terminology.

• Knowledge of revenue cycle processes affecting reimbursement, including intake, admissions, registration, billing, accounts receivable, collections, cash posting, payor logs, file maintenance, aging AR management, reporting, day-endand month-end closing.

• Understanding ofmedical terminology.

• Knowledge and understanding of Explanation of Benefits (EOB), contract language, and state/federal guidelinesrequired.

• Knowledge of working with Electronic Health Records or related healthcare systems.

• Skilled in makingaccuratearithmetic computations.

• Ability to understand and interpret reason for underpayments, or overpayments.

• Display excellent communication skills (verbal & written), good judgement, tact, initiative, and resourcefulness.

• Must be detail oriented, organized, and ability to multi-task.

• Ability todemonstratesupportiverelationshipswith peers,clients,partners,andcorporateexecutives.

• Demonstrate the ability to build andmaintainstrong internaland externalrelationships.

• Utilize critical thinking skills to resolveagedand problematic accounts.

• Mustbeflexiblewitha "cando" attitudeandcanremainprofessionalunderhighpressuresituations.

• Retain and protect confidential material.

Training and Experience:

• MEDHOST(HMS)Contract Management experience is a plus.

• 3years ormoreexperience incontract management or relevant hospitalrevenue cycleexperience.

• Follow directions and perform work according to department standards; work performed self-independently & team player.

• Sufficientcomputer skills in Microsoft Office applications (i.e., Word, Excel, PowerPoint, etc.) to complete work assigned.

• Customer Serviceoriented.

Other Requirements:

• High Speed Internet access (minimum 300 Mbps download speed) and unlimited data

• Smart phone for Multi Factor Authentication (MFA) application