Responsible for entering all cash receipts and denials into the billing system while maintaining a high level of productivity through speed and accuracy.
Applies all payments to patient and guarantor accounts, including payments from insurance carriers, government agencies and their fiscal intermediaries, patients and product suppliers.
Reconciles cash posting to deposits on a daily/monthly basis.
Reviews and posts denials from payers and recommends solutions to management.
Analyzes third party payer amounts paid to contracted reimbursement rates. Alerts management of material differences in these amounts.
Analyses 835 ERAs from payers and alerts management of changes in allowed amounts, adjustment reason codes, amounts paid, etc from historical trends. .
Reviews each lockbox entry/remittance advice to verify accuracy of amount. Apply payments in accordance to the reimbursement policy and procedure.
Identify and resolve payment issues timely.
Cross check accounts with payor contract to verify accuracy in processing and/or posting payments.
Demonstrates accountability and responsiveness to the needs of the patients of CCS Medical.
Participates in educational programs and in-service meetings on product information and new procedures.
Maintains and promotes patient confidentiality.
Maintains open lines of communication with Administration, department management and other departmental personnel.
Follows all Medicare, Medicaid and Private Insurance regulations and requirements.
Actively participates in Continuous Quality Improvement.
Demonstrates thoroughness with all work related activities. Strives to continually improve quality and productivity results displayed by Department Personnel on an ongoing basis.
Assumes other duties and responsibilities as assigned by managment.
Abides by all policies, procedures and protocols set forth by CCS Medical.
Maintains scheduling flexibility to ensure availability to meet the needs of the department for all hours of operation.
Maintains regular and consistent attendance.
High school diploma or GED equivalent.
Minimum of one year pervious healthcare experience necessary. Must be knowledgeable of reimbursement processes and procedures.
Experience in cash posting and ANSI X12 835 for auto posting processes preferred.
Ability to add, subtract, multiply and divide all units of measure, using whole numbers, common fractions and decimals.
Proficient in basic PC skills. (MS Office)
Organized work habits, accuracy, and proven attention to detail, with strong analytical skills.
Ability to work within a team setting and as an individual contributor.
Excellent oral and written communication skills.
Self-directed with the ability to work with little or no supervision.
Flexible and cooperative in fulfilling all obligations.
Ability, flexibility, and willingness to learn and grow as the company expands and changes.
Ability to recommend and implement changes to processes for efficiency.
Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals; ability to write routine reports and correspondence; ability to speak effectively before groups of customers or employees of the organization.