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Employment Type:Full timeShift:Description:Provides extensive support covering all aspects of registration related billing claims edits (pre A/R) to submit clean claims to the third-party payers. Responsible for analyzing and working reports/edits for review and to correct demographic, insurance, provider, and charge information as required and according to payer guidelines to ensure claims are billed out accurately and processed for payment timely. Works closely with other departments and multiple specialties to obtain required information and for root cause analysis.Knows, understands, incorporates, and demonstrates the mission, vision, and values of Trinity Health in leadership, behaviors, practices, and decisions.Reconciles and corrects Patient Access related held claims and/or follows up on edits by correcting and/or collaborating with various departments to correct for resubmission.Applies updates to all necessary systems to correct accounts and ensure clean processing upon the next billing cycle.Verifies that pre-bill claims are passing internal edits in a timely fashion.Ensures claims are submitted in the proper format as defined by the requirements in the facility’s various Third-Party Payer contracts.May reaches out to a specific payer, provider, or patient to resolve the edit.Follows data entry guidelines by payer type and billing area.Verifies insurance via system, website, or phone.Adds and understands specific data such as modifiers, occurrence codes, value codes, condition codes, payer specific information.Resolves problems by clarifying issues; researching and exploring answers and alternative solutions; implementing solution and /or escalating unresolved accounts to Manager.Maintains knowledge of current reimbursement trends and developments in hospital registration and billing.Identifies registration edit issues, data entry problems and/or educational needs and opportunities to reduce denials and increase payment and communicate trends to the Manager.Escalates situations/issues to Manager, as appropriate.Maintains access to, and security of, highly sensitive materials. Promotes confidentiality and uses discretion when handling patient information.Communicates quality and / or compliance issues to management.Meets productivity standards, targets, error ratios and reporting requirements as assigned by the department Manager.Participates in department meetings and training seminars as assigned by the department Manager.Participates in the testing for assigned software applications, including verification of field integrity.Partners with end users to provide education on errors and prevention steps.Other duties as needed and assigned by the manager.Maintains a working level knowledge of applicable Federal, State and local laws and regulations, Trinity Health’s Corporate Integrity Program, Code of Ethics, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical and professional behaviorOur Commitment to Diversity and InclusionTrinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law.Our Commitment to Diversity and InclusionTrinity Health is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians across 25 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions.Our dedication to diversity includes a unified workforce (through training and education, recruitment, retention, and development), commitment and accountability, communication, community partnerships, and supplier diversity.EOE including disability/veteran
