Located in Broomfield, CO., and as part of the Cash Management team, this position is responsible for reviewing and identifying overpayments, and processing refunds.
1. Resolve both undistributed and credit balance accounts while working from an assigned work list.
2. Research all aspects of the claim cycle to identify and correct errors which cause misappropriated funds. Document all actions taken on the electronic patient account.
3. Verify payer remittance to apply payments appropriately. Utilize resources to find payment documentation. Interpret payer contracts to ensure all codes on patient's account matches or contracts. Reviews EOB to make sure payments were applied correctly, insurance processes correctly, and the posting is correct. Understand how to evaluate over payments.
4. Trains new and existing associates for Patient Account Credits. Serves as a subject matter expert for the Credits Team and acts as interdepartmental liaison. Actively identifies opportunities for process improvement within the Cash Management Department. Creates documented workflows and tip sheets for use within the department. Completes payment reviews on complex accounts.
High School Diploma or Equivalent
Two (2) years of experience in revenue cycle with one (1) of years in patient account credits or insurance follow up experience required.
Hospital/physician billing or claims follow-up experience.
Previous experience in Insurance denials and appeals, and payment posting.
Advanced understanding of insurance remits.
Advanced proficiency of EPIC Resolute Hospital Billing.
Demonstrates initiative and is able to see issues through to resolution.
Understanding of complete revenue cycle from patient charge entry to applying payment.
Proficient with MS Office programs including Word and Excel.
Knowledge of general medical billing, insurance, and compliance regulations and coding.