Job Description:
- Verifies In-Patient and Out-Patient hospital claim benefits.
- Prepares and submits hospital claims to commercial and third party payers.
- Responsible for timely management of all accounts within coverage area.
- Negotiates claims with non-contracted payers to ensure highest return and prompt payment.
- Conducts routine follow up with payers for claim status.
- Files timely appeals on denied or incorrectly processed claims.
- Responsible for detailed EOB analysis.
- Enters finalized accounting metrics into NHPN database.
- Responsible for maintaining high collectability percentage on outstanding AR.
- Reviews past due claims to determine the nature and extent of the delay and appropriate action required.
- Maintains consistent cash flow, low aging, and low DSO metrics.
- Communicates with hospital staff to obtain additional information as needed.
- Contacts patients to facilitate timely receipt of information, when applicable.
- Responds to insurance payer and/or patient inquiries in a timely manner.
- Prepares, analyzes and maintains records and reports documenting the status of all accounts.
- Attends conference calls and in-person offsite meetings with the facilities to review account summary and data analysis.
- Responds to incoming correspondence from payers or patients.
- Performs other related duties as assigned or requested. *The company reserves the right to add or change duties at any time.
Experience:
- Minimum Education: Associate’s degree.
- Minimum Experience: 3 Years.
- Minimum Field-of-Expertise: Medical services collections and computerized billing systems such as IDX, Navinet, etc. Working knowledge of laws governing collections efforts, insurance and medical terminology, and reimbursement procedures.
Skills:
- Balance figures
- Microsoft Excel
- SQL/Access (a plus)
- Assemble and organize numerical data
- Draft routine correspondence
- Understand and apply Insurance policies and procedures
- Maintain accurate filing systems
- Detailed and thorough research
- Advanced use of computerized spreadsheets
- Excellent written and verbal communication
Apply:
Please email your resumes with salary requirements to hr@nhpn.net or fax us at 610.230.0903.