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Company Name : Sutter Health
Location : Salt Lake City, UT 84107
Position : Team Member, Claims-Work from Home
Job Description : Position Overview:
Supports the delivery of all billing services by final/higher level auditing, correcting, and submitting 3rd party claims and patient statements. Ensures that billing services are timely, accurate, and appropriate reimbursement. Conducts all claims related follow up on payment delays, taking corrective action(s) to finalize account disposition and/or referring claims to the appropriate staff so as to ensure appropriate reimbursement in the most timely manner possible.
Qualifications:
Education:
Associate’s Degree in Accounting or Business or the equivalent education/experience required
Experience:
Demonstrates experience and a proven track record in Payer-specific (Medicare, MediCal, Medicaid, and/or Private) Claims in a facility of significant size and complexity, hospital business operations, information systems, and patient accounting applications, as typically acquired in 0-2 years of acute hospital patient accounting positions required
Experience participating in Payer-specific (Medicare, MediCal, Medicaid, and/or Private) Claims standards, processes, policies, procedures and service level agreements is required
Experience in complex regional/ shared service environment with multiple/ matrix reporting relationships desired
Skills and Knowledge:
In-depth knowledge of various insurance documentation requirements, the patient accounting system, and various data entry codes to ensure proper service documentation and billing of the patient’s account
Knowledge of insurance and governmental programs, regulations and billing processes (e.g., Medicare, MediCal, Medicaid, Social Security Disability, Champus, Supplemental Security Income Disability, etc.), commercial third party payers, and/or managed care contracts and coordination of benefits
Familiarity with medical terminology and the medical record coding process
In-depth knowledge of Revenue Cycle applications, including Hospital Patient Accounting
In-depth knowledge/ awareness of all areas related to Payer-specific (Medicare, MediCal, Medicaid, and/or Private) Claims and how they interrelate
Knowledge of principles, methods, and techniques related to compliant healthcare billing/collections
Familiarity with Payer-specific (Medicare, MediCal, Medicaid, Private) Claims management functions in acute and non-acute settings
Knowledge of Patient Management information system applications, preferably EPIC
Ability to execute strategy and communicate knowledge of business processes and enabling technologies, specifically in a Payer-specific (Medicare, MediCal, Medicaid, and/or Private) Claims function
Ability to comprehend and retain information that can be applied to work procedures to achieve appropriate service delivery
Data entry skills (minimum 50-60 accurate keystrokes per minute)
Requires strong accuracy, attentiveness to detail and time management skills
Aptitude to conceptualize, plan, and implement stated goals and objectives
Ability to independently set and organize own work priorities for self, and successfully adapt to new priorities as part of a changing environment. Must be able to work concurrently on a variety of tasks/projects in an environment that demands a high degree of accuracy and productivity in cooperation with individuals having diverse personalities and work styles
Ability to communicate and work with patients, physicians, associates, Sutter Health leadership, multiple direct patient care providers and others in order to expedite the patient accounting process. Strong communication skills (verbal and written) in dealing with trainees, associates, and internal/external customers
Ability to comply with Sutter Health policies and procedures
Excellent ability to identify, prioritize, resolve and / or escalate complex problems promptly
Excellent ability to establish, develop and manage customer relationships
Ability to learn new applications/software systems effectively and efficiently
Ability to communicate ideas both verbally and in writing to interact with others using on-on-one contact and group discussions
Ability to recognize the appropriate style, level of detail, and message for the audience
Ability to develop effective working relationships/ networks within and outside the organization
Skills using spreadsheet, word processing, and basic statistical software applications, preferably Microsoft Suite
Well-developed process design, implementation, and improvement skills
High-level problem identification/ mitigation/ resolution and analytical skills
Requires the ability to work with and maintain confidential information
Organization:Sutter Shared Services
Employee Status: Regular
Employee Referral Bonus: No
Benefits: Yes
Position Status: Non-Exempt
Union: No
Job Shift: Day/Evening
Shift Hours:8 Hour Shift
Days of the Week Scheduled:Monday-Friday
Weekend Requirements: Other
Schedule: Full Time
Hrs Per 2wk Pay Period:80
Applications Accepted:All Applications Accepted
This post is listed Under Utah jobs
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