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Overview

Work Hours: Full-time 8a-4:30p

The ideal candidate must be able to work in a call center environment with medical terminology knowledge.

Description

JOB DESCRIPTION:

• As part of a team or works independently to resolve complex patient account issues.

• Collects and follows up on all accounts assigned prior to, during, or after admission and discharge.

• Serves as patient advocate during the cycle of the account.

• Responsible for accurate posting of insurance company and patient payments, including accurate contractual adjustments and denials.

• Responsible for complete and accurate resolution of credit balance invoices through telephone, mail, and research efforts.

• Maintains up-to-date knowledge of insurance plans and current contracts, co-payments and deductibles.

• Interfaces successfully with insurance carriers.

• Maintains knowledge of current government and hospital contracts and working knowledge of co-payments and deductibles.

• Maintains and is familiar with UB and HCFA Billing Manuals.

• Coordinates classification for bad debt and charity.

• Maintains knowledge and is familiar with Patient Accounting system.

• Independently assesses Claim Edit, Transaction Editing System, Clearinghouse, or other applicable billing edit messages to resolve any issues preventing release of physician or hospital claims from Emory's systems.

• With increasing self-sufficiency, understand and efficiently handle all aspects of insurance verification.

• This includes maintaining up-to-date knowledge of insurance rules, referral requirements, payor websites, eligibility portals, and Emorys verification systems.

• With increasing self-sufficiency, provide thorough customer service, including robust knowledge of specialty billing practices (e.g. explain anesthesia billing to patients inquiring about medical direction modifiers by rote).

• Must demonstrate a working knowledge of CPT, ICD-10, modifiers, coding and documentation guidelines.

• Payment Posting specialists must demonstrate strict adherence to write-off policies, refund policies and other accounts receivable policies as outlined to maintain compliance.

• Under supervision, responsible for reviewing scheduled elective accounts to ensure that certification has been obtained.

MINIMUM QUALIFICATION:

• High school diploma or equivalent.

• Two (2) years of collections, billing, and/or registration experience in a healthcare or insurance setting OR any combination of equivalent education and experience.

• Certified Patient Accounts Representative (CPAR) and/or Certified Patient Financial Counselor (CPFC) preferred for positions in the hospital setting.

• Typing skills with a minimum of 35 wpm and good communication skills.

PHYSICAL REQUIREMENTS (MediumMax 25lbs): up to 25 lbs, 0-33% of the work day (occasionally); 11-25 lbs, 34-66% of the workday (frequently); 01-10 lbs, 67-100% of the workday (constantly); Lifting 25 lbs max; Carrying of objects up to 25 lbs; Occasional to frequent standing & walking, Occasional sitting, Close eye work (computers, typing, reading, writing), Physical demands may vary depending on assigned work area and work tasks.

ENVIRONMENTAL FACTORS: Factors affecting environment conditions may vary depending on the assigned work area and tasks. Environmental exposures include, but are not limited to: Blood-borne pathogen exposure Bio-hazardous waste Chemicals/gases/fumes/vapors Communicable diseases Electrical shock , Floor Surfaces, Hot/Cold Temperatures, Indoor/Outdoor conditions, Latex, Lighting, Patient care/handling injuries, Radiation , Shift work, Travel may be required. Use of personal protective equipment, including respirators, environmental conditions may vary depending on assigned work area and work tasks.

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Division The Emory Clinic

Campus Location Decatur, GA, 30030

Campus Location US-GA-Decatur

Department TEC PFS Customer Svc Collectio

Job Type Regular Full-Time

Job Number 63765

Job Category Revenue Cycle & Managed Care

Schedule 8a-4:30p

Standard Hours 40 Hours

Emory Healthcare is an Equal Employment Opportunity employer committed to providing equal opportunity in all of its employment practices and decisions. Emory Healthcare prohibits discrimination, harassment, and retaliation in employment based on race, color, religion, national origin, sex, sexual orientation, gender identity or expression, pregnancy, age (40 and over), disability, citizenship, genetic information, service in the uniformed services, veteran status or any other classification protected by applicable federal, state, or local law.