- Provides feedback / education to staff to prevent reoccurrence of insurance account issues.
- Ability to analyze trends and determine root cause of billing problems.
- Maintains knowledge of all Federal and state billing regulations and guidelines.
- Prepares and reviews reports/ documents with appropriate staff as required.
- Identifies opportunities for improvement within MMS CBO/Practice work flow processes.
- Demonstrates ability to identify issues outside work flow process and escalates them when necessary.
- Identifies and monitors incorrect reimbursement and coding issues.
- Identifies and applies appropriate adjustments per contracts or state requirements.
- Follows-up on all previously sent reconsiderations for proper payment.
- Communicates with payors regarding issues and resolutions.
- Performs other duties as assigned
- Bachelor's Degree (Required)
- No Certification, Competency or License Required
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Operations Analyst - Charleston, United States - CAMC Health System
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Description
Job SummaryResearches, identifies, and rectifies any circumstances affecting delayed submission of insurance accounts or payment of accounts.
Responsibilities
Patient Group Knowledge (Only applies to positions with direct patient contact) The employee must possess/obtain (by the end of the orientation period) and demonstrate the knowledge and skills necessary to provide developmentally appropriate assessment, treatment or care as defined by the department's identified patient ages.
Competency Statement Must demonstrate competency through an initial orientation and ongoing competency validation to independently perform tasks and additional duties as specified in the job description and the unit/department specific competency checklist.
Common Duties and Responsibilities (Essential duties common to all positions) 1. Maintain and document all applicable required education. 2. Demonstrate positive customer service and co-worker relations. 3. Comply with the company's attendance policy. 4. Participate in the continuous, quality improvement activities of the department and institution. 5. Perform work in a cost effective manner. 6.Perform work in accordance with all departmental pay practices and scheduling policies, including but not limited to, overtime, various shift work, and on-call situations.
7. Perform work in alignment with the overall mission and strategic plan of the organization. 8. Follow organizational and departmental policies and procedures, as applicable. 9. Perform related duties as assigned.Education
Credentials
Status: Full Time Regular
Location: General-MSOB
Location of Job: US:WV:Charleston
Talent Acquisition Specialist: Anita J. Ferguson