Billing and Collections Associate 1 - Danbury Health Systems : Job Details

uvance Health has a network of convenient hospital and outpatient locations - Danbury Hospital, New Milford Hospital, Norwalk Hospital and Sharon Hospital in Connecticut, and Northern Dutchess Hospital, Putnam Hospital Center, and Vassar Brothers Medical Center in New York - plus multiple primary and specialty care physician practices locations, including The Heart Center, a leading provider of cardiology care, and two urgent care offices. Non-acute care is offered through various affiliates, including the Thompson House for rehabilitation and skilled nursing services, and the Home Care organizations.

TITLE: Billing and Collections Associate

DEPARTMENT: Patient Financial Services

REPORTS TO: Manager of Billing & Collections

LOCATION: Danbury, CT (2 days onsite and 3 days remote)

SUMMARY:This position is responsible for a variety of duties including, billing, collection, follow-up, appeals process, and credits to support the Health Quest System Business Office in delivering the highest level of service. The team performs, and all job-related duties as assigned.

RESPONSIBILITIES AND STANDARDS:

Assumes responsibility for the timely, accurate, and compliant BILLING activities for the Health Quest hospitals, including but not limited to:

* Review and edit demographic information and other Pre-Billing functions

* Process claims through electronic system correcting all errors prior to submission

* Validate claims sent are received by Payer (NEIC report)

* Enters all transactional comments into the system to assure accurate account documentation

* Meets performance goals as defined by senior management (ex: clean claim rate, etc.)

* Meets productivity and quality metrics daily/weekly

* Maintains current knowledge of hospitals' billing systems

* Maintains current knowledge of billing forms and filing requirements

* Maintains a current knowledge of various payer contracts

* Maintains current knowledge of Federal, State, and managed care billing methodologies, rules, and regulations

Responsible for the FOLLOW-UP AND COLLECTION activities of the Health Quest hospitals, including but not limited to:

* Works accounts according to the priority determined by the electronic worklist

* Corresponds with third-party payers, physician offices, and/or patients to obtain information

* Escalates problems and high dollar accounts to the Supervisor for guidance and support; per guidelines stated in the PDU Policy and Procedure document

* Meets performance goals as defined by senior management (ex: A/R > 90 days, credit balance reasons, etc.)

* Meet daily and weekly productivity and quality goals

* Informs Supervisors/Managers of key issues on a timely basis communicating key observations, issues, and trends

* Enters all transactional comments into the system to assure accurate account documentation

* Maintains current knowledge of effective follow-up and collection approaches

* Maintains current knowledge of timely payment regulations and holds payers accountable. Escalates non-compliance to senior management

* Maintains current knowledge of hospitals' patient accounting systems (and other related tools)

* Reviews credited accounts and processes insurance refunds

JOB QUALIFICATIONS:

Education: Requires a High School Diploma or GED

Experience: A minimum of one year in patient accounting preferred

Knowledge: Medical Terminology, Knowledge of ICD-9 and CPT-4 codes, excellent verbal and written communication skills, attention to detail, general math skills documentation skills, and knowledge of procedures and revenue cycle flow in a healthcare organization.

License: N/A

PHYSICAL AND MENTAL FACTORS:

Physical: Occasionally requires light physical effort as in periods of standing at files or work tables, repeated changes of position within the work routine, or prolonged sitting.

Mental:

ENVIRONMENTAL AND WORKING CONDITIONS:

Some minor physical inconveniences or discomfort routinely present in the work situation

Location: The Summit at Danbury

Work Type: Full-Time

Standard Hours: 40.00

FTE: 1.000000

Work Schedule: DAY 1

Work Shift: 8am - 4:30pm 8 hour shifts

Org Unit: 1017

Department: Patient Accounting

Exempt: No

EOE, including disability/vets.

We will endeavor to make a reasonable accommodation to the known physical or mental limitations of a qualified applicant with a disability unless the accommodation would impose an undue hardship on the operation of our business. If you believe you require such assistance to complete this form or to participate in an interview, please contact Human Resources at 203-###-#### (for reasonable accommodation requests only). Please provide all information requested to assure that you are considered for current or future opportunities.

Salary Range: 15.3-28.22