Job Description

Posted Date: 9/10/2019

Position Summary

This position is responsible for the resolution of outstanding and/or denied claims based on third party claim processing rules within established timelines. The Revenue Cycle Associate reports to the central business office supervisor or manager.

Key Responsibilities

  • Meets goals and objectives in assigned area;
  • Complies daily with departmental policies and procedures;
  • Performs collection activity to ensure proper resolution and reimbursement on claims;
  • Provides thorough, courteous, and professional assistance to coworkers and patients;
  • Ensures that all claims are billed and collected and meet all government mandated policies for Integrity and Compliance;
  • Collaborates with hospital departments in the resolution of accounts;
  • Resolves claims processing issues with third party payers and provide all required information timely; involves patients and family members (where necessary) to ensure timely resolution of claims with insurance companies;
  • Resubmits clean and accurate claims to insurance companies in a timely and compliant manner;
  • Researches, prepares, and submits appeals to insurance companies;
  • Details all actions taken on account with clear and concise notes;
  • Monitors and recognizes denials and/or issues that may be trends and escalate to supervisor as needed; and
  • Maintain strict confidentiality and adhere to all HIPAA guidelines/regulations.

Required Knowledge and Skills

  • Knowledge of basic medical coding/terminology and third-party insurance operating procedures and practices a plus;
  • Understands payer guidelines related to effective claim resolution;
  • Knowledgeable and proficient with payer websites and other useful resources;
  • Knowledge of revenue cycle and/or business office procedures;
  • Highly detail oriented and organized;
  • Ability to read, understand, and follow oral and written instructions; and
  • Ability to establish and maintain effective working relationships and communicate clearly with customers and insurance companies both within and outside of Steward.

Background and Experience

  • High school diploma or GED required
  • 1-2 years’ related experience preferred
  • MS Office experience required

Application Instructions

Please click on the link below to apply for this position. A new window will open and direct you to apply at our corporate careers page. We look forward to hearing from you!

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