Adjustment Analyst

4 weeks ago

Fayetteville, North Carolina, United States Washington Regional Medical Center Full time

Job Details

Job Location: Washington Regional Med. Ctr. - Fayetteville, AR

Position Type: Full Time

Education Level: High School Diploma or GED

Salary Range: Undisclosed

Job Shift: Day

Job Category: Admissions & Billing Services

Description

Position Summary

The role of the Adjustment Analyst reports to the corresponding Billing Manager. This position is responsible for providing account follow up of Washington Regional Hospital and Clinic claims. This position oversees research and resolution of insurance billing issues at the time of claims submission, receipt of denial or non-contracted payment, and refund requests. This position must have the ability to learn and understand multiple software systems.

Essential Position Responsibilities

  • Receive and research insurance remittances, payor correspondence, or Clearinghouse rejections in an accurate and timely manner
  • Ensure all denials are forwarded to appropriate personnel within a timely manner
  • Provide effective communication with patients, insurance companies, and staff
  • Collaborate with necessary departments to ensure overall account accuracy and issue resolutions
  • Reconcile transactions to ensure payments are balanced
  • Provide timely and efficient follow-up on all outstanding AR using assigned ATB worklist reports, using various systems including: Payor portals, Payor phone inquiries and/or written communications
  • Assigned to specific insurance(s) and providers/specialties but expected to learn on the job other insurances and specialties for career growth
  • Maintain current assigned insurance(s) guidelines, policies, and procedures related to payment of claims

Qualifications

  • Education: High School graduate or GED
  • Licensure and Certifications: N/A
  • Experience:
  • Previous billing and claims experience within a hospital and/or clinic business office with 2+ year experience, preferred.
  • Basic working knowledge of the MS Office suite of software, and the ability to operate standard office equipment.
  • Broad knowledge of medical terminology, medical collections, MS-DRG coding methodology, ICD-10 and CPT coding, preferred.

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