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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 complex tactical and analytical patient accounting functions related to: insurance billing, self-pay billing, remit analysis & cash posting, accounts receivable management, claims follow up, charge capture and analysis, denials analysis & resolution and tasks to support the Consortium’s month end close processes. This role is vital to ensuring the timely and complete conversion of the Consortium’s net patient accounts receivable into cash to fund day to day operations and growth initiatives that benefit the communities we serve.
Charge Capture & Billing: Ensure proper charge capture, 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; Manage billing scrubber edits and identity root causes impacting clean claim rates; Assist with other special projects related to charge capture and billing/rebill projects. Identify, analyze, and reconcile billing errors or omissions.
Insurance Follow-Up: Monitor payor claim acceptance and response timeliness; when necessary, call, email, use payor portals to status claims; responsible for reviewing patient account records and third party payer issues; escalate themes for potentially payor relations bulk resolution; Be familiar with standard concepts, practices, and procedures in healthcare.
Self-Pay Billing & Follow-Up: Validate balance, bill and follow-up on patient self-pay accounts consistent with the Consortium’s discount, bad debt and charity policies. Locate and monitor delinquent patient self-pay accounts, notify patients of delinquent accounts by mail or telephone, and arrange for debt repayment. Answer patient billing questions and take necessary action to resolve the account. Recommend accounts for placement with bad debt agencies or charity write-off; collaborate with financial counselors to identify alternative funding sources for patients
Cash Posting & ERA Management: Accurately and post 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-post-able 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. Decipher Explanation of Benefits (EOB) and balance transfer money to the secondary insurance or patient liability. Become familiar with and able to identify issues related to automated posting processes using 835 and 835-like files; post incoming claim denials and work closely with the billing/denials team to document within denials log and ensure proper follow up and appeals. Sorting, scanning, organizing, and handing off correspondence related to patient accounts.
Process, sort, and log incoming mail. Print, scan, and organize correspondence such as EOBs, letters, and denials. Log denials and work closely with billing to ensure proper follow up. Enter account history notes when necessary for billing team follow up. Hand off other correspondence to proper staff for follow up.
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.
Education/Experience
High School diploma or equivalent.
1 year experience in billing, collections, and cash posting
Knowledge, Skills & AbilitiesKnowledge
Basic knowledge of hospital or clinic billing and follow up
Basic knowledge of payor remittances
Knowledge of medical terminology
Demonstrate basic knowledge of CPT’s, HCPCS, and Revenue Codes
Basic knowledge of major insurance companies billing policies to ensure compliance
Basic knowledge of insurance claim forms
General knowledge of specific specialties within the hospital or clinic billing area
Working knowledge of Microsoft Office Software programs
Knowledge of reconciling and balancing of payments received against account receivables
Proficient using a keyboard and 10 key
Highly motivated, self-starter
Attention to detail and accuracy
Skills
Good organizational skills
Good communication skills both orally and written
Problem solving and decision making skills
Abilities
Ability to collaborate within cross-functional teams
Ability to work in a fast paced setting
Job ID: 2019-1861 External Company Name: SouthEast Alaska Regional Health Consortium External Company URL: https://searhc.org/
