Patient Financial Service Representative - Reimbursement & Reconciliation

Location

Morristown, NJ | United States

Job description

Atlantic Health System is seeking a full-time Patient Financial Srv Rep. for PFS Customer Service to work from 8:00 AM to 4:00 PM. (Corporate Building South Street, Morristown NJ)

Essential Funtions:

Responsible for ensuring that unpaid and partially paid claims are resolved in an efficient and timely manner. Resolves EOB discrepancies and researches refunds.

• Monitors and ensures that collections, net, gross and days in accounts receivable targets are met.
• Follows up on submitted claims, monitors unpaid claims and resubmits claims with appropriate corrections and documentation
  Works declines, and processes appeals
• Ensures that established billing targets for collections, gross, days in A/R and net collection ratios are met
• May analyze claims system reports to ensure that underpayments are correctly identified and collected from key carriers
• Works with payer and provider representatives to negotiate higher rates for claim payments
• Responds to patient and third-party inquiries, researches and resolves complex claims and corrects errors
• Reviews correspondence and rejection data from insurance carriers; posts rejections and performs reconciliations
• May transfer secondary balances to appropriate financial class and provide documentation for processing the claims
• Reviews Credit Letter Sent (CLS) and transfers balance to appropriate financial class and dunning level
• May process refunds for supervisory approval
• Maintains strictest confidentiality; adheres to all HIPAA and Federal Payor guidelines and regulations
• Meets the daily productivity call and accounts
• Performs other related duties

Education:

• College degree required

Requirements:

• Familiarity with ICD9, ICD-10, preferred, CPT codes and DRG’s. Ability to analyze a UB04 and Explanation of Benefits.
  Computer Skills: Must be proficient in Microsoft Outlook, Work and Excel. EPIC knowledge a plus.
  Prior Office / Call center preferred

Job tags

Salary