Job Description

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Job Summary

Provide optimum assistance to the Patient Financial Services Analysts in supporting a successful revenue cycle for CAMC Health System.

Responsibilities

Research missing charges and post them to accounts timely and accurately to facilitate appropriate billing and reimbursement.

Analyze and adjudicate Uninsured/Unassigned claims submitted by physicians and process payments to physicians.

Analyze Exception Reports to identify and correct accounts still in a Pre-Registration status to ensure correct billing and reduce delays in reimbursement.

Analyze insurance errors in order to correct insurances to match account type and correct insurance priorities.

Process errors daily from the TCE daily error report to ensure all charges, payments, and adjustments are resolved daily. Work closely with PFS Analysts, Manager, and Director to identify errors and proactively seek resolution to reduce and prevent errors.

Maintain training materials for new hires and current employees. Update as needed with direction from Analysts.

Analyze assigned QUIC worklists to ensure they are completely resolved each week.

Maintain all financial information for the Radiation Therapy Department, and reconcile all variances to the General Ledger by working with the accounting department.

Complete projects and assignments from the PFS Analysts.

Create reports as needed.

Initiate and answer routine correspondence or inquiries.

Analyzes charges registered for the Ryan White Grant program and works closely with the clinic director to adjudicate claims and reconcile charges. Must identify any issues and identify a resolution for processing problems.

HCA Monthly Inpatient Discharge reconciliation.

Maintain a thorough understanding of PFS procedures and Revenue Cycle fundamentals and workflow.

Participate as an active member on assigned teams to accomplish department, Finance, and system goals.

Knowledge, Skills & Abilities

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\xe2\x80\x99s identified patient ages. Specifically the employee must be able to demonstrate competency in: 1) ability to obtain and interpret information in terms of patient needs; 2) knowledge of growth and development; and 3) understanding of the range of treatment needed by the patients. 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.

Maintain and document all applicable required education.

Demonstrate positive customer service and co-worker relations.

Comply with the company\'s attendance policy.

Participate in the continuous, quality improvement activities of the department and institution.

Perform work in a cost effective manner.

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.

Perform work in alignment with the overall mission and strategic plan of the organization.

Follow organizational and departmental policies and procedures, as applicable.

Perform related duties as assigned.

Education

• Bachelor\'s Degree (Required) Experience: 1-2 years Accounts Receivable and Third Party Reimbursement Substitution: May substitute Associate Degree with 2 years experience OR 7 years experience OR Applicable certification with 2 years experience for Bachelors Degree Experience: 1-2 years Accounts Receivable and Third Party Reimbursement Substitution: May substitute Associate Degree with 2 years experience OR 7 years experience OR Applicable certification with 2 years experience for Bachelors Degree

Credentials

• No Certification, Competency or License Required

Work Schedule: Days

Status: Full Time Regular

Location: General Hospital

Location of Job: US:WV:Charleston

Talent Acquisition Specialist: Chet A. Harless chet.harless@vandaliahealth.org

Charleston Area Medical Center