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Patient Health Benefits Specialist
4 months ago
Patient Health Benefits Specialist page is loaded
Patient Health Benefits Specialist
Apply
locations
AK - Sitka
time type
Full time
posted on
Posted 5 Days Ago
job requisition id
2023-7272
Pay Range:
$22.74 - $28.43
SEARHC
is a non-profit health consortium which serves the health interests of the residents of Southeast Alaska. We see our employees as our strongest assets. It is our priority to further their development and our organization by aiding in their professional advancement.
Working at SEARHC is more than a job, it’s a fulfilling career. We offer generous benefits, including retirement, paid time off, paid parental leave, health, dental, and vision benefits, life insurance and long and short-term disability, and more.
Performs a variety of patient accounting functions including insurance billing, self-pay billing, remit analysis & cash posting, accounts receivable management, claims follow up, charge validation and analysis, denials analysis & resolution and tasks to support the Consortium’s month end close processes.
Key Essential Functions and Accountabilities of the Job
Validates changes and billing information
Validates proper charge codes, billing, and adjudication of claims in accordance with standard federal, state and private billing policies and reimbursement principles
Stays current on changing payor-specific charging and billing rules.
Assists with other special projects related to billing/rebill projects.
Identifies, analyzes, and reconciles billing errors or omissions.
Provides service to customers, answering questions and resolving issues
Answers patient billing questions and takes necessary action to resolve the account
Validates balance, bills and follows-up on patient self-pay accounts consistent with the Consortium’s discount, bad debt and charity policies.
Locates and monitors delinquent patient self-pay accounts, notifies patients of delinquent accounts by mail or telephone, and arranges for debt repayment.
Collaborates with financial counselors to identify alternative funding sources for patients
Reconciles payments
Logs all transactions posted to the organization’s bank account into the cash log and allocates all monies to the appropriate EHR system or identifies as a general ledger transaction.
Balances all transactions posted to source system and daily batch
deposits.
Researches and resolves un-applied cash and misapplied payment research requests.
Communicates effectively with the cash posting team and participates and contributes constructively to produce results in a cooperative effort to ensure that all funds are processed, scanned and batched for posting within established service levels.
Processes incoming mail
Prints, scans, and organizes correspondence such as EOBs, letters, and denials.
Downloads back-up for clinic deposits in the PFS shared drive folders.
Logs denials and works closely with billing to ensure proper follow up.
Enters account history notes when necessary for billing team follow up.
Hands off other correspondence to proper staff for follow up.
Facilitates insurance and patient refunds and ensures all back-up is scanned into refund log. Assists in communication of strategies or messages from senior leadership
Cash Posting & ERA Management: Accurately posts all cash, checks, credit cards, and electronically transferred funds to beneficiary and non-beneficiary accounts within 3 business days of cash deposit or escalate non-postable deposits for resolution;
Researches and resolves un-applied cash and misapplied payment research requests;
Balances all transactions posted to source system and daily batch deposits.
Deciphers Explanation of Benefits (EOB) and balances transfer money to the secondary insurance or patient liability.
Resolves rejected electronic transactions and assists with the identification and implementation of new payers for electronic transactions; posts incoming claim denials and work closely with the billing/denials team to document within denials log and ensure proper follow up and appeals.
Other Functions
Participates in development and updating of organization procedures and update of forms and manuals.
Performs a variety of general clerical duties and other routine functions
Other duties as assigned
Supervisory Responsibilities
This position does not require supervisory responsibilities.
Education, Certifications, and Licenses Required:
High school diploma or equivalent – required
Associates degree in related field – preferred
Certified CRCR (HFMA-Medical), CRCS (AAHAM-Medical), or CDBS (ADCA-Dental). Current employee must be in good standing to qualify for employer-paid certification
Experience Required:
Two years of experience in billing, collections and/or cash posting – required
Knowledge of:
Knowledge of hospital or clinic billing and follow up and medical terminology
Knowledge of payor remittances and basic knowledge of CPT’s, HCPCS, and Revenue Codes
Knowledge of major insurance companies' billing policies to ensure compliance and insurance claim forms
Knowledge of specific specialties within the hospital or clinic billing area
Knowledge of reconciling and balancing of payments received against account receivables
Skills in:
Using a keyboard and 10-key
Problem solving, decision making and detail orientation
Verbal and written communication
Ability to:
Collaborate within cross-functional teams
Work in a fast-paced setting
Travel Required:
Less than 10% travel expected.
Required Certifications :
Certified Revenue Cycle Representative - American Association of Healthcare Administration Management
If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us
About Southeast Alaska Regional Health Consortium
We Want You to Join our Team
Southeast Alaska is home to some of the world’s most breathtaking landscapes, proudest Native cultures, and thriving pioneer spirits. SouthEast Alaska Regional Health Consortium (SEARHC) helps to keep it healthy.
Every career with SEARHC comes with a positive work culture, a team with shared values, and competitive benefits. SEARHC offers sign-on bonuses for Registered Nurses, Hot Jobs and Certified Nurses Assistants.
At SEARHC, we are passionate about enhancing the health and wellbeing of our team as well as the communities we serve.
We Embody our Values:
Respect
Cultural Identity
Service
Professionalism
Compassion
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