Apply for JobJob ID90826LocationAurora, ColoradoFull/Part TimeFull-TimeRegular/TemporaryRegularAdd to Favorite JobsWhy Work at Children's.Here, it's different. Come join us.
Children's Hospital Colorado has defined and delivered pediatric healthcare
excellence for more than 100 years.
Here, the nation's brightest nurses, physicians, scientists,
researchers, therapists, and care providers are creating the future of
child health. With an optimist's outlook, a trailblazing spirit, and a
celebrated history, we're making new strides every day.
We've been Magnet-designated four times by the American Nurses Credentialing
Center and are consistently recognized among the best of the best pediatric
hospitals with #1 rankings in Colorado and the region by U.S. News & World
Report.
As a national leader in pediatric care, we serve children and families from
all over the nation. Our System of Care includes four pediatric hospitals,
11 specialty care centers, 1,300+ outreach clinics and more than
10,000 healthcare professionals representing the full spectrum of pediatric
care specialties.
Here, we know it takes all of us, every role, to deliver the best
possible care to each child and family we treat.
That's why we build our teams toward a foundation of equity in access,
advancement, and opportunity. We know teams of individuals with different
identities and backgrounds can nurture creativity and innovation. We know we
can see, treat, and heal children better when our team reflects the
diversity of our patient population. We strive to attract and retain diverse
talent because we know a truly inclusive and equitable workforce will help us
one day realize our most basic calling: to heal every child who comes
through o
A career at Children's Colorado will challenge you, inspire you, and
motivate you to make a difference in the life of a child. Here, it's
different.Job OverviewThis is an advanced-level variance (credit and/or debit) position within
the Patient Financial Services team. The position ensures reconciliation of
patient accounts with enhanced EOB/insurance processing understanding,
accurate and timely response to payers' correspondence, advanced credit
account review with understanding of contract summaries and application to
account types, and collaboration with across Revenue Cycle and appropriate
departments on accounts during discrepancies. Has in depth ability to
recognize deviations from contractual expectation and payor activities or
decisions, recognize gaps in payment/reasoning or system errors and handle
escalated, complex accounts, and is capable of auditing accounts for
accuracy and working accounts to completion/resolution. Identifies trends or
gaps where appropriate and follows through to ensure solutions.Additional InformationDepartment Name: Patient Financial Services
Job Status: Full time 40 hours per week.
Shift:Day shift flexible hours from 6am to 6pm.QualificationsEducation: High School Diploma or equivalent required.
Experience: Minimum five (5) years of healthcare and/or accounts
receivable experience.ResponsibilitiesPOPULATION SPECIFIC CARE No direct patient care.
ESSENTIAL FUNCTIONS
An employee in this position may be called upon to do any or all of the
following essential functions. These examples do not include all of the
functions which the employee may be expected to perform.
Reads and interprets EOB/insurance processing to understand and work and
resolve accounts.
Reads, understands, and interprets contracts and contract summaries to
advise correct applications for an account.
Recognizes and solves for deviations from contractual expectation and payor
activities/decisions, recognize gaps in payment/reasoning or system errors.
Will work projects such as Novita's, Medicaid and Medicare Audits,
HMS. Supports and completes audit processes.
Investigates and resolves assigned credit a d/or debit balance accounts.
Issue insurance refunds when appropriate.
Calculates, corresponds on, and corrects contractual adjustments based
on insurance contracts.
Intermediate trending and analysis - identifying root cause and
solution-oriented mindset. Recognize and call out trends within payers and
escalate as appropriate.
Proficiently discusses accounts, records, and service with
patients/insurance, as needed.
Collaborates with patients, vendors, and internal departments to resolve
conflicts on accounts and resolve any outstanding credit and/or debit
balances of unapplied/unidentified payment receipts.
Identifies and prioritizes accounts and WQs, based on scoring, type,
payor, dollar, etc.
