Job Location : Little Rock,AR, USA
ARKANSAS CHILDREN'S IS A TOBACCO FREE WORKPLACE. FLU VACCINES ARE REQUIRED. ARKANSAS CHILDREN'S IS AN EQUAL OPPORTUNITY EMPLOYER. ALL QUALIFIED APPLICANTS WILL RECEIVE CONSIDERATION FOR EMPLOYMENT WITHOUT REGARD TO RACE, COLOR, RELIGION, SEX, SEXUAL ORIENTATION, GENDER IDENTITY OR EXPRESSION, NATIONAL ORIGIN, AGE, DISABILITY, PROTECTED VETERAN STATUS OR ANY OTHER CHARACTERISTIC PROTECTED BY FEDERAL, STATE, OR LOCAL LAWS.
CURRENT EMPLOYEES: Please apply via the internal career site by logging into your Workday Account ( search the Find Jobs report.
Work Shift:
Day Shift
Time Type:
Full time
Department:
CC017090 Patient Financial Services
Summary:
Monday - Friday, 8:00 a.m. - 5:00 p.m. - Hybrid (On-site as needed)
Prepares accurate and complete medical claims/billings for timely submission to third-party payers. Responsible for follow-up and collection activities to assure prompt and proper payment from third-party payers. Responsible for knowledge of medical billing requirements and software products essential to performing job duties. Analyzes claims for payment. Resolves denials. Identifies problem trends and works to resolve.
Additional Information:
Monday - Friday, 8:00 a.m. - 5:00 p.m. - Hybrid (On-site as needed)
#AC2024
Required Education:
Bachelors Degree or Equivalent Experience
Recommended Education:
Required Work Experience:
Related Field - No experience required
Recommended Work Experience:
Administrative Support - Direct_Epic experience
Required Certifications:
Recommended Certifications:
Description
1. Analyzes medical claims to assure they are complete and accurate and have any required attachments before being filed to payer (clean claim).
2. Expedites proper adjudication of claims by payer to maximize reimbursement and minimize older age accounts. Identifies claims that have not been adjudicated and assures they are adjudicated promptly. Analyzes reason given for claim not being adjudicated and how we might overcome lack of adjudication.
3. Reviews adjudicated claims to assure they were properly adjudicated with the proper payment amount and to assure that unpaid amounts are valid and properly categorized. Appeals claims that are improperly adjudicated so they are promptly corrected.
4. Identifies problems and patterns, quantifies, reports and resolves problems.
5. Establishes effective working relationships with internal and external customers to expedite creation of clean claims and prompt and proper adjudication of claims. Communicates technical information accurately and effectively whether in writing or orally. Excellent ability to think on feet.
6. Performs other duties as assigned.