Req#: R34772
Category(s): Finance, Accounts Receivable
Full Time / Part Time: Full-Time
Shift: First
Location: 280 Chestnut, Springfield MA (option hybrid after training)
Schedule: Monday-Friday; 730a-4p; 40hrs weekly
Under the direction of the Manager, Business Systems Support, this position is responsible for identifying, reporting and rectifying credit balances and other problem accounts. Other related duties may apply, as required.
Job Responsibilities:1) Verifies material/information received from the system, such as patient level information, date of service, procedure codes, charge amount, etc. Transfers appropriate balances to secondary insurance or self pay. Follows credit balance procedures to return duplicate payments or unidentified funds to sender.
2) Records productivity and other information required for established reports. Identifies duplicate payments, funds belonging to other Baystate departments or other entities.
3) Reviews and processes credit balances on a daily basis. Gathers and organizes required back-up materials to support prompt resolution of credit balances (i.e., Request forms, claims, and EOBs).
4) Posts and documents the refund check information within the patient's account. Mails the refund checks to the appropriate party including any back up documentation necessary.
5) Completes the take-back retraction requests to the insurance carriers that do not accept refund checks. Provides supervisor with weekly and monthly summaries of credit resolution issues as requested.
6) Reviews the Credit Resolution Associates refund request for accuracy and supporting documentation. Identifies, analyzes and resolves trends.
7) Provides oversight in the absence of the supervisor. Acts as a liaison with the IS staff to identify system based problems and create process efficiencies. Assists with the training of new staff members.
8) Maintains current knowledge of IDX and CSC systems, payment posting policies and procedures. Gives advanced attention to detail. Excellent oral and written communication skills.
9) Maintains regulatory compliance in all credit balance scenarios. Cross-trains in other disciplines where coordination and back-up are necessary. Skills in grammar and spelling to be utilized in patient and insurance correspondence.
10) Ability to maintain confidentiality of sensitive information as mandated by HIPAA. Ability to change priorities to meet work changes and coordinate priorities with the PBO Leadership Team on projects that may be necessary
Required Work Experience:1) Advanced knowledge of IDX required
2) Minimum of three years related physician billing required
Preferred Work Experience:1) None Listed
Skills and Competencies:1) Advanced PC Skills and ability to operate a variety of other necessary office equipment
2) Strong typing/number pad skills to meet/exceed production expectations
3) Minimum typing speed of35 words per minute
4) Knowledge of medical terminology
5) Knowledge of elementary accounting principles
6) Ability to prioritize and organize
7) Ability to work independently in a fast paced environment
8) Ability to manage complexities of payer adjudication of claims and coordination of benefits
You Belong At Baystate
At Baystate Health we know that treating one another with dignity and equity is what elevates respect for our patients and staff. It makes us not just an organization, but also a community where you belong. It is how we advance the care and enhance the lives of all people.
DIVERSE TEAMS. DIVERSE PATIENTS. DIVERSE LOCATIONS.
Education:
GED or HiSET (Required)
Certifications:
Equal Employment Opportunity Employer
Baystate Health is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, marital status, national origin, ancestry, age, genetic information, disability, or protected veteran status.
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