Account Resolution 2 MGBO

2 weeks ago

Fairburn, Georgia, United States WellStar Health System Full time

Facility:
VIRTUAL-GA

Job Summary:

The Account Resolution II representative is responsible for ensuring all eligible accounts are reviewed appealed within the designated payer timeframes and are documented appropriately in the patient accounting system.

Additionally, the Account Resolution II representative will be responsible for the tracking and trending of recovery efforts by utilizing various departmental tools and appropriately reporting on-going problems specific to payers, health system departments, and/or contracts.

The Account Resolution II representative will work collaboratively with their Team Lead, Manager and other area Leaders to ensure necessary communication and feedback to the departments take place in a timely manner.

The Account Resolution II representative serves as a mentor to Account Resolution I representatives as well as own several inter/intradepartmental projects.


Core Responsibilities and Essential Functions:
Duties and Responsibilities
  • Collect and resolve payments from insurance companies by working with assigned payers and utlizing Policies and Procedures
  • Execute and assist team members with the denial appeals process, which includes receiving, assessing, documenting, tracking, responding to, and/or resolving appeals with third party payers in a timely manner.
Research and resolve payer rejected/denied claims and analyze accounts for insurance payment accuracy/completeness and for payer claim processing accuracy per contract. Work with clinical staff as needed to follow-up and appeal denials. Follow Adjustment Policy for denials where efforts have been exhausted.
  • Maintain data on the types of claims denied and root causes of denials, and collaborate with team members to make recommendations for improvement and issue resolution
  • Prepare, maintain, assist with and submit reports as required.
  • Track and trend recovery efforts by utilizing various departmental tools.
Escalate on-going problems to Manager/Team Lead for appropriate action to resolve.
  • Provide feedback and process improvement ideas to management regarding facility, Patient Access, Case Management, HIM, Billing and/or payer issues identified when reviewing accounts for appeal
  • Identify contract issues related to denials and no response; communicate those issues to the team Manager.
  • Provide on going feedback to clinical staff about denial reasons, appeals and their outcomes, and managed care contractual requirements.
  • Transmit required documentation to Government and third party payers for the purpose of resolving payments
  • Ensure all payer contact is fully documented in the appropriate software application
  • Ensure claims are crossed over to secondary insurances, reporting any delay in unbilled secondary claims to the unit supervisor
  • Consistently meet the current productivity standards in addressing and resolving accounts.
  • Consistently meet the current quality standards in taking appropriate actions to identify and track root causes, successfully appeal denied accounts, and trend issues, avoid excessive deferred accounts.
Help Team Lead and Manager educate team appropriately.
  • Complete special projects as assigned.
Management
  • Provide individual contribution to the overall team effort of achieving the department AR goal
  • Identify opportunities for system and process improvement and submit to management
  • Demonstrate proficient use of systems and execution of processes in all areas of responsibilities
  • Follow the health systems general Policy and Procedures, the Departments Policy and Procedures, and the Emergency Preparedness Procedures
  • Become cross trained and fill in for other staff as assigned.
Train new employees.
  • Administer quality audits as assigned by Manager or Director.
Administrative
  • Professional Communication
  • Assure patient privacy and confidentiality as appropriate or required
  • Communicate in a professional manner with patients, their families and representatives from third party payor organizations including physicians, physician staff, co workers, management and clinical staff.
  • Maintain professional relationships and convey relevant information to other members of the healthcare team within the facility and any applicable referral agencies
  • Initiate communication with peers about changes and procedures
  • Interact with internal customers including HIM, Revenue Integrity, Patient Access, and the SBO in a professional manner to achieve revenue cycle department AR goals and objectives
  • Department Methods/Procedures/Operations
  • Follow department guidelines for lunch, breaks, requesting time off, and shift assignments
  • Operate office equipment and machinery and utilizes ergonomic workstations, equipment, and supplies
  • Follow JCAHO and outside regulatory agencies mandated rules and procedures
  • Utilize assigned menus and pathways in foreign software applications.
Report software application problems to the appropriate supervisor - Perform other duties and responsibilities as assigned

Required Minimum Education:

High school diploma Required or equivalent Required Required Minimum License(s) and Certification(s): All certifications are required upon hire unless otherwise stated.

Additional License(s) and Certification(s):

Required Minimum Experience:
Minimum 3 years collection experience and/or with a Hospital Information System or PC-based application Required and Less than 1 year experience as an Account Resolution I or equivalent

Required Required Minimum Skills:

Excellent communication skills when dealing with patients, families, public, co-workers, and professional offices to include oral and written comprehension and expression.

Basic knowledge of medical terminology Ability to perform mathematical calculations with high-level problem solving, analytical and investigational skills Detail-oriented, good organizational skills, and ability to be self-directed Strong time management skills.

Ability to learn quickly and meet continuous timelines managing multiple priorities and a heavy workload in a high-stress atmosphere.

Demonstrat flexibility to perform other tasks as needed in an active work environment with changing work needs Ability and willingness to exhibit behaviors consistent with principles of excellent service and team collaboration.

Ability and willingness to demonstrate and maintain competency as required for job title and the unit/area(s) of assignment Ability and willingness to exhibit behaviors consistent with standards of performance improvement and organizational values (e.g.

, efficiency & financial responsibility, safety, partnership & service, teamwork, compassion, integrity, and trust & respect)

  • Office Supervisor

    2 weeks ago

    Fairburn, Georgia, United States NFI Industries Full time

    The Office Supervisor directs, administers, supervises and supports all aspects of the administrative functions as well as supports Operations Management in their area of responsibility. Typically supports at least one customer account, and has at least 2 CSR staff responsibility and reports to General Manager.Shift Available: 1st, Monday- Friday, 7AM-...

  • Logistics Coordinator 1st shift

    4 weeks ago

    Fairburn, Georgia, United States syncreon America Inc Full time

    Are you a proactive person who enjoys solving problems and formulating ideas to make a difference for your company? We are looking for an experienced Logistic Coordinator, based in Fairburn, GA, to plan, direct and coordinate the operations at the facility. It's an exciting time to join the syncreon teamAbout the RoleHow you will contribute Handle customer...

  • Lead Operations 2nd

    2 weeks ago

    Fairburn, Georgia, United States Electrolux Full time

    Supply ChainPermanentJob DescriptionFor us going to work every day has an even greater purpose than putting the latest product or technology on the market. It's about improving the everyday lives of millions. By being sustainable and open to new ideas we can push the boundaries of cooking, cleaning, and wellbeing at home. But to keep doing so, we need more...

  • Warehouse Team Leader- 2nd Shift

    2 weeks ago

    Fairburn, Georgia, United States Duracell Full time

    ResponsibilitiesAs a Warehouse Team Lead your essential duties and responsibilities include, but not limited to: Manage day-to-day operation of the warehouse on second and third shift (i.e. Receiving, put away, bulk storage, picking for production, return to warehouse, inspection, scrap, finished good recording, case and pallet label printing, line cycle...

  • Account Resolution 2 MGBO

    4 weeks ago

    Fairburn, United States WellStar Health System Full time

    Facility: VIRTUAL-GA Job Summary: The Account Resolution II representative is responsible for ensuring all eligible accounts are reviewed appealed within the designated payer timeframes and are documented appropriately in the patient accounting system. Additionally, the Account Resolution II representative will be responsible for the tracking and trending...

  • Account Resolution 2 MGBO

    4 weeks ago

    Fairburn, United States WellStar Health System Full time

    Facility: VIRTUAL-GAJob Summary: The Account Resolution II representative is responsible for ensuring all eligible accounts are reviewed appealed within the designated payer timeframes and are documented appropriately in the patient accounting system. Additionally, the Account Resolution II representative will be responsible for the tracking and trending of...

  • Operations Lead-2

    3 weeks ago

    Fairburn, United States Electrolux Full time

    Supply Chain Permanent Job Description For us going to work every day has an even greater purpose than putting the latest product or technology on the market. It's about improving the everyday lives of millions. By being sustainable and open to new ideas we can push the boundaries of cooking, cleaning, and wellbeing at home. But to keep doing so, we need...

  • Restaurant General Manager

    4 weeks ago

    Fairburn, United States Taco Bell Full time

    Restaurant General Manager Fairburn, GA " You are applying for work with a franchisee of Taco Bell, not Taco Bell Corp. or any of its affiliates. If hired, the franchisee will be your only employer. Franchisees are independent business owners who set their own wage and benefit programs that can vary among franchisees." General Manager Job...

  • Group Coordinator Lead

    4 weeks ago

    Fairburn, United States DPDHL Full time

    DHL Supply Chain is Hiring! At DHL, you will play a part in one of the world’s most essential industries. As the world’s leading contract logistics provider, we believe in doing the right thing, growing together, and delivering the difference. At DHL, you have a voice that matters and can make an impact that lasts. There has never been a better time to...

  • Freight Specialist

    3 weeks ago

    Fairburn, United States TOTO USA, Inc. Full time

    **JOB TITLE**: Freight Specialist**DEPARTMENT**: EXIM**SUMMARY**: - Receives, verifies, stores and distributes all information related to import and export shipments of materials, products and supplies within the department. The Freight Specialist acts as an import and export liaison between vendors, customers, accounting department, purchasing department,...

  • Head Teller

    4 weeks ago

    Fairburn, United States Ameris Bank Full time

    Ameris Bank is a purpose-driven company, dedicated to bringing financial peace of mind to communities, one person at a time. Whether a customer wants to grow their business, buy a home, or feel confident in their retirement plan, they have a partner in Ameris Bank. We serve customers in our locations across the Southeast, Mid-Atlantic and nationwide through...

  • Office Supervisor

    2 weeks ago

    Fairburn, United States Ryder System, Inc. Full time

    RyderOffice Supervisor Fairburn, GA, 30213, USA Job Seekers can review the Job Applicant Privacy Policy by clicking HERE. () We are immediately hiring an Office Supervisor i n Fairburn, GA for our Supply Chain Solutions division. We are taking over a distribution center in Fairburn and are looking for qualified individuals to work for Ryder...

  • Logistics Coordinator 1st shift

    3 weeks ago

    Fairburn, United States syncreon Full time

    Are you a proactive person who enjoys solving problems and formulating ideas to make a difference for your company? We are looking for an experienced Logistic Coordinator, based in Fairburn, GA, to plan, direct and coordinate the operations at the facility. It's an exciting time to join the syncreon team! About the Role How you will contribute Handle...

  • Office Clerk

    4 weeks ago

    Fairburn, United States Carvana Full time

    About Us ADESA, a Carvana-owned company, currently operates in over 50 locations throughout the US. Our auto auctions some up to 200 acres, provide a wide array of vehicle services including repair, reconditioning, and auction remarketing, and many of our sites serve as market hub distribution centers. Our inventory comprises hundreds of thousands of...

  • Director of Night Warehouse

    4 weeks ago

    Fairburn, United States US Foods, Inc. Full time

    ESSENTIAL DUTIES AND RESPONSIBILITIES  • Achieve all safety, service, and cost targets in department, and oversee all night warehouse operations. Plan and oversee execution of short/mid-term department objectives. Participate in strategic planning by identifying mid and long-term strategies for the department. Direct management to bring about action...

  • Director of Night Warehouse

    4 weeks ago

    Fairburn, United States US Foods, Inc. Full time

    ESSENTIAL DUTIES AND RESPONSIBILITIES  • Achieve all safety, service, and cost targets in department, and oversee all night warehouse operations. Plan and oversee execution of short/mid-term department objectives. Participate in strategic planning by identifying mid and long-term strategies for the department. Direct management to bring about action...

  • Group Coordinator Lead

    4 weeks ago

    Fairburn, United States DHL (Deutsche Post) Full time

    DHL Supply Chain is Hiring! At DHL, you will play a part in one of the world's most essential industries. As the world's leading contract logistics provider, we believe in doing the right thing, growing together, and delivering the difference. At DHL, you have a voice that matters and can make an impact that lasts. There has never been a better time to join...

  • Store Manager

    2 weeks ago

    Fairburn, United States Cricket Wireless Full time

    At One Outsourcing, an Authorized Retailer for Cricket Wireless, we pride ourselves in providing a simple, smart, make-your-day-better wireless experience for anyone who wants first-class nationwide wireless service at a value price, with no annual contract. Cricket Wireless powers a nationwide network that covers more than 308 million customers. Want to...

  • Front Office Specialist

    4 days ago

    Fairburn, United States Wellstar Health System, Inc. Full time

    Facility: Wellstar North Douglas OB/GYN Job Summary:The Front Office Specialist (FOS) is responsible for illustrating exceptional customer service and focus to WellStar's patients and customers. This includes greeting customers, registering patients at check-in and check out, answering telephones, scheduling appointments, cash management, and/or...

  • Instrument and Controls Technician

    4 weeks ago

    Fairburn, United States Duracell Full time

    **As an Instrument Controls Technician, some of your essential duties and responsibilities may include**: - Make electrical repairs to modern high-speed packaging equipment. - Perform preventive/predictive electrical maintenance tasks. - Analyzing and addressing the root causes of electrical issues in order to repair complex electrical equipment. -...

  • Instrument and Controls Technician

    3 days ago

    Fairburn, United States Duracell Full time

    Job DescriptionAs an Instrument Controls Technician, some of your essential duties and responsibilities may include: Make electrical repairs to modern high-speed packaging equipment. Perform preventive/predictive electrical maintenance tasks . Analyzing and addressing the root causes of electrical issues in order to repair complex electrical equipment....

  • Instrument and Controls Technician

    3 days ago

    Fairburn, United States Duracell Full time

    Job DescriptionAs an Instrument Controls Technician, some of your essential duties and responsibilities may include: Make electrical repairs to modern high-speed packaging equipment. Perform preventive/predictive electrical maintenance tasks . Analyzing and addressing the root causes of electrical issues in order to repair complex electrical equipment....

  • Instrument and Controls Technician

    2 days ago

    Fairburn, United States Duracell Full time

    Job DescriptionAs an Instrument Controls Technician, some of your essential duties and responsibilities may include: Make electrical repairs to modern high-speed packaging equipment. Perform preventive/predictive electrical maintenance tasks . Analyzing and addressing the root causes of electrical issues in order to repair complex electrical equipment....

  • Instrument and Controls Technician

    7 hours ago

    Fairburn, United States Duracell Full time

    Job DescriptionAs an Instrument Controls Technician, some of your essential duties and responsibilities may include: Make electrical repairs to modern high-speed packaging equipment. Perform preventive/predictive electrical maintenance tasks . Analyzing and addressing the root causes of electrical issues in order to repair complex electrical equipment....