Job DetailsLevel: EntryJob Location: Hudson, WI - Hudson, WI 54016Position Type: Full TimeEducation Level: Not SpecifiedTravel Percentage: NoneJob Shift: AnyJOB SUMMARY: The primary purpose of this position is to facilitate all aspects of non-clinical patient services, with a focus on insurance processing specific to claim denials and follow up. The function of this position is to provide all facets of services related to Business Services. Position will be staffed during clinic hours and is fully remote. Training will be completed remotely. ESSENTIAL DUTIES AND RESPONSIBILITIES: \tReview and process daily and monthly work queues of aging and reports to ensure claims are being processed in a timely manner. \tAnswer and respond to patient inquiries related to claims processing. \tMaintain all records for assigned insurance encounter types. \tEffectively communicate with insurance payers by insurance portal, phone and/or written correspondence. \tReview accounts for correct insurance loading and insurance filing. \tReview accounts for proper application of payments, adjustments, denials, refunds and or credit balances. \tReview claim status messages in electronic systems and make appropriate changes. \tAppropriately submit corrected claims and appeals for unpaid and/or denied charges according to health plans policy requirements and AUC standards. \tRequest claim review from coding, when appropriate. \tMonitor assigned health plan news and communicate appropriately to the group on any policy and procedural changes that impact practice policies. \tDemonstrate the ability to recognize trends with claim processing and denials. SUPPLEMENTAL DUTIES AND RESPONSIBILITIES: \tMaintain confidentiality. \tEstablish and maintain positive working relationships. \tWork independently with minimal instruction in team environment. \tAttend training sessions, in-services, departmental and facility meetings. \tAdheres to the philosophy and provides comprehensive care according to a patient centered healthcare clinic. \tPerform other duties and responsibilities as required or assigned by the Revenue Cycle leadership. \tAbility to multi-task and meet daily, weekly and monthly deadlines. WORKING CONDITIONS: 1. Subject to interruptions, imposed deadlines and frequent problem-solving activities. 2. May be subject to hostile and emotionally upset patients, staff, and personnel from other agencies. 3. Standard Office Environment. PHYSICAL DEMANDS: \tAbide by ergonomic recommendations of the position. \tMust possess sight/hearing senses or use prosthetic devices that will enable these senses to function adequately. \tSit for several hours. \tRepetitive motions involving use of phone and keyboard. QualificationsEDUCATION: \tMinimum: High School Diploma or equivalent \tDesired: Post-secondary education. EXPERIENCE: \tMinimum: 1-2 years in Healthcare Business Office. \tDesired: 2-4 years Insurance Billing and Accounts Receivable KNOWLEDGE: 1. Advanced knowledge and understanding of remittance advice (EOB) statements. 2. Proficient working knowledge of ICD10 and CMS billing guidelines. 3. Knowledge of PC, Windows and Microsoft Office specific to Excel. 4. Knowledge of medical terminology and healthcare insurance. 5. Good grammar, spelling and communication skills. .
