Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines.
Today at Penn Medicine, someone will make a breakthrough. Someone will heal a heart, deliver hopeful news, and give comfort and reassurance. Our employees shape our future each day. Are you living your life's work?
The Reimbursement Specialist will be responsible for Home-Related Third-Party Billing and/or Collection Activities. Duties include but are not limited to: complete daily billing process in an efficient and timely manner, resolve and work billing edits reports timely and accurately, and complete assigned billing projects, as needed. Review and work AR weekly and/or monthly reports for assigned collection activity.
• Organized, efficient, and timely processing of all billing activities throughout the month, especially upon monthly accounting close.
• Collection of same accounts utilizing current system AR reports as a tool/guideline.
• Ensure Adjustments and Write-offs are submitted regularly and appropriately investigated for accuracy before approval from Manager. Maintain a clear and concise understanding of the adjustment codes.
• Conduct research and investigate any charges denied for lack of authorization and/or out of range date span. Provide supporting data to the Authorization Management Team to assist in any denials of charges. Initiate appeals and submit supporting documentation for reconsideration of denial.
• Maintenance of electronic billing initiatives and files for transmission to Clearinghouse.
• Resolution of all on-going payer issues via appropriate contacts/parties at the insurance company. Utilization of all insurance-provided tools for greater and more efficient collection activity. Report all payer trends to Management.
• Problem-solve and identify software issues and/or user issues with all Clearinghouse transmissions.
• Expectation of 95 percent accuracy rate in both quality and quantity of reimbursement activities.
• All Reimbursement responsibilities must be balanced daily, with workload met in a systematic approach. Bills are always given first priority within the assigned work queue. Billers are expected to complete assigned "A" list, while maintaining established productivity standards for billing.
• Maintain open communication with Management on billing issues and systematic issues. Accountable for communication of issue(s) to all parties and implementing corrective action plans when necessary. Work closely with in-house clinical managers and/or Director to ensure appropriate service delivery and financial accountability. Work closely with co-workers and Manager on any assigned projects or reports.
• Assist with cash posting duties when necessary including transfers, credit balance review and refund entries. Participate in and support initiatives for Departmental Performance Improvement and Project Management.
• Maintain current knowledge of industry specific trends and authorization information per Managed Care company in matters of Reimbursement and Regulatory policies/practices.
• Performs duties in accordance with Penn Medicine and entity values, policies, and procedures
• Other duties as assigned to support the unit, department, entity, and health system organization
A H.S. Diploma or GED is required, plus at least 2 years of experience in a healthcare environment, preferably a home healthcare setting.
A Bachelor's Degree is preferred, and would require at least 1 year of experience in a Health Care environment, preferably in a home health setting
Demonstrated interpersonal/verbal communication skills
Ability to use machines/tools: Fax, Computer, Copier with Scanner Capabilities required.
Must possess good problem-solving skills
Must exercise independent judgement and responsibility with minimal supervision
Must be able to work under pressure of deadlines
Ability to recognize and document problem areas in billing and suggest solutions preferred
Must have familiarity with generic billing formats (such as New 1500 and the UB04 billing forms)
We believe that the best care for our patients starts with the best care for our employees. Our employee benefits programs help our employees get healthy and stay healthy. We offer a comprehensive compensation and benefits program that includes one of the finest prepaid tuition assistance programs in the region. Penn Medicine employees are actively engaged and committed to our mission. Together we will continue to make medical advances that help people live longer, healthier lives.
Penn Medicine http://www.pennmedicine.org/careers/
Live Your Life's Work
We are an Equal Opportunity and Affirmative Action employer. Candidates are considered for employment without regard to race, ethnicity, color, sex, sexual orientation, gender identity, religion, national origin, ancestry, age, disability, marital status, familial status, genetic information, domestic or sexual violence victim status, citizenship status, military status, status as a protected veteran or any other status protected by applicable law.
Posting ID: 576553258Posted: 2020-09-30