- Reviews outstanding claims to determine what action needs to take place. Establishes priorities and direction with aged receivables.
- Works payer rejections, returned claims, correspondence and denials to achieve maximum reimbursement in a timely manner with an emphasis on patient satisfaction.
- Monitors reimbursement from managed care networks and insurance carriers to ensure reimbursement is consistent with contract rates.
- May correct errors including misapplied payments/adjustments and applies account credits, when applicable.
- Reads and interprets EOBs and ERAs with knowledge and understanding.
- Evaluates patient's accounts to validate charges and payments to prepare accounts for the refunds process.
- Reviews refunds prepared by other staff members.
- Creates daily deposit batches for Billing & Posting Coordinator.
- Models and reinforces Ashley's mission and core values
- Performs other duties on an as-needed basis
- Reinforces Ashley's commitment to diversity, equity and inclusion
- Protects the privacy of our patient's protected health information by maintaining compliance with HIPAA and other relevant Ashley related IT security regulations
- GED or High School Diploma, required.
- 2-years proven work experience in insurance/patient billing and healthcare claims processing and follow-up background, required.
- Strong knowledge on third party payers guidelines and procedures required.
- Experience and/or knowledge of insurance denials process.
- Ability to calculate figures with accuracy.
- Demonstrates accuracy and thoroughness; monitors own work to ensure proper reconciliation.
- Basic knowledge of Microsoft Office to include Outlook, Word and Excel.
- Display willingness to make decisions, exhibit sound and accurate judgment, support and explain reasoning for decisions/actions.
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Patient Financial Services Analyst - Belcamp, United States - Ashley Addiction Treatment
Description
Job Description
Job DescriptionTHE ORGANIZATION
Ashley Addiction Treatment Center was founded in 1983 by two visionaries who knew the treatment of drug or alcohol addiction could be designed and effectively delivered in a holistic manner that compassionately considers the whole person and not just the disease. Innovative then, and innovative now, Ashley passionately continues its core mission "To transform and save human lives by integrating the science of medicine, the art of therapy, and the compassion of spirituality." Organizationally strong, the organization rigorously adheres to its guiding principles, ethics, and a culture of excellence.
POSITION SUMMARY
Resolution of insurance and patient receivables and collections. Processes patient refunds. Payment reconciliation on insurance and patient payments. Prepares and submits claims and statements to various insurance companies/patients either electronically or by paper.
KEY RESPONSIBILITIES
In addition to role responsibilities, each staff member of Ashley, Inc. has the following responsibilities as a part of their employment:
DESIRED KNOWLEDGE/SKILLS/ABILITIES:
Ashley is committed to maintaining a work environment in which all of its employees are treated fairly with respect and dignity. Ashely prohibits discrimination and harassment based upon an individual's race, color, religion, national origin, age, marital status, military/veteran status, sexual orientation, gender identity or expression, pregnancy, genetic information, disability, or any other characteristic protected by applicable law.
