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Company :Allegheny Health NetworkJob Description :GENERAL OVERVIEWCoordinates financial activities and provides customer support.ESSENTIAL RESPONSIBILITIES
Counsels patients and families regarding insurance coverage, medical policy and all other aspects related to the financial and billing process. Assists patients regarding alternate funding agencies and resources. (20%)
Collects payments and reconciles accounts according to established fee schedules. (20%)
Negotiates with external agencies, insurance carriers, providers, patients, etc for information/documentation, payment settlements, authorization issues, and resolution of benefit issues. (20%)
Monitors outstanding accounts and informs management of backlog issues. Resolves and addresses issues and deficiencies related to reimbursement and denials. Notifies management of any barriers effecting reimbursement. (10%)
Provides analytical support for identification and notification of trends, and regulatory changes. (10%)
Provides staff resources or technical guidance and problem resolution related to insurance verification, billing, collections, and financial counseling processes. (10%)
Identifies work flow issues such as duplication of efforts, need for automation of manual processes, need for written work flow procedures, failure to utilize existing computerized system capabilities. Provides continuous quality improvement through system analysis, making recommendations, and implementing work flow changes. (10%)
Performs other duties as assigned or required.
QUALIFICATIONSMinimum
BA/BS Degree preferred.
Minimum 4 years experience performing collections, benefits verification, and customer service.
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