To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values-integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.
Processes and records all monetary transactions within the hospitals to ensure accurate cash flow for each institution. Maintains smooth internal and external communication to ensure positive customer relations and timely application of all transactions. Performs a variety of duties necessary to ensure that all transactions are correctly applied to each account. Analyzes, processes, and balances all payments received for patient accounts.
Responsibilities: 1. Analyzing and Processing Electronic Remittances: Receives, processes and balances electronic remittances daily to ensure proper and timely application of these transactions. 1.1. Accesses remittance file from appropriate clearing houses. 1.2. Interfaces data from the clearing houses into Epic automatically creating a batch for posting. 1.3. Resolves errors by identifying and tracing patients or adjusting account numbers to rectify the error and posts to the existing batch. 1.4. Creates a new batch to accommodate any errors that cannot be reconciled immediately and requires further tracking (i.e. Contact third parties for further information). 1.5. When analyzing each batch, determines amount of payment to be applied to the General Ledger (i.e. non-patient cash) and then communicates amount and back up (i.e. copy of payment) to Accounting. 1.6. Determines where payments belong when received for other organizations (i.e. occupational health, dental, and Yale University) and transfers to the appropriate accounts via General Ledger. 2. Analyzing and Processing Payments via Insurance Lockbox: Receives, processes and balances payments from insurance lockbox to ensure proper and timely application of these transactions to the appropriate accounts in Epic. 2.1. On a daily basis, retrieves transaction sheets from the lockbox website. 2.2. Posts each transaction sheet total to a hospital clearing account in Epic for tracking. 2.3. Responsible for obtaining sheets that have been posted to the clearing account to redistribute the payments to the patient accounts accurately. 2.4. Balances each transaction sheet and removes the posted amount from the clearing account in Epic. 2.5. Resolves other items in the clearing that require further research, such as contacting carriers or other members of the SBO. 3. Patient Payments: Processes payments via patient lockbox and self-service/point of service on-line portal for each hospital and corporate accounts. 3.1. Runs daily reports from patient lockbox site and processes daily corresponding posting file. 3.2. Runs daily reports from self-service/point of service on-line portal and processes daily corresponding posting file. 3.3. Runs associated error report via Epic. 3.4. Identifies and resolves all errors from report and discrepancies to ensure posting file and repost balance. 4. Undistributed Work Queue Functions: On a daily basis, works the undistributed work queue by analyzing each account to ensure proper application of payments. 4.1. Identifies those transactions that were posted to the undistributed bucket on a patient's account to be worked. 4.2. Identifies the payer and amount of reimbursement to determine if coverage needs to be added. 4.3. Applies payments to appropriate bucket to resolve account in work queue. 4.4. Documents the account history with detailed notes of any and all changes. 5. Computer Systems: Demonstrates a thorough understanding of the Epic system and other related systems in order to perform all job duties including batch processing. 5.1. Uses extensive knowledge of Epic system to correctly identify interfaces that affect batches. 5.2. Creates new batch, identifies errors, retrieves and re-applies batches when necessary. 5.3. Maintains proper audit trail. 5.4. Documents all relevant activity on interfaces and/or accounts with clear concise notes for follow-up and tracing purposes. 6. Main Deposit: Demonstrates a thorough understanding of all procedures to compile the main deposit. 6.1. Responsible for creating a reconciliation sheet for all items processed daily. 6.2. Compiles the reconciliation sheet by hospital into one main deposit via an Excel spreadsheet. 6.3. Runs proper system reports (i.e. Epic and legacy) to ensure balancing. 6.4. On a daily basis, reports the figures to leadership via email. 7. Safekeeping: Receives, verifies and records all safekeeping bags on a daily basis to ensure proper handling of patient's belongings. 7.1. Maintains a legible logbook with an index and records all safekeeping numbers in numeric sequence. 7.2. Dispenses safekeeping items by requesting and recording proper I.D. and signatures, always notating information and the date transactions took place. 7.3. Sends certified letters on unclaimed safekeeping items within 60 days. 7.4. Notes all transactions in safekeeping. 7.5. Main deposit personnel must check overnight box for safekeeping on a daily basis and notes any discrepancies from log book. 8. Window Transactions: Receives, processes, balances and records all monetary transactions from the window to ensure a timely (daily) application of all transactions. Responds to questions from the public and provides coin needs to the hospital while always maintaining a high security environment. 8.1. Responds to routine questions relating to hospital information. 8.2. Always maintains a high security environment to ensure safety and control of the work area. The cash box must always be locked when unattended. 8.3. Ensures accuracy in balancing, receiving, processing and recording all hospital monetary transactions on a daily basis. Scans all items to be forwarded to the SBO. 8.4. Supplies the coin needs for the entire hospital complex to ensure adequate level of funds for change.
High school graduate with business or accounting related courses. Associate's degree in a business related field preferred, or equivalent work experience.
One (1) to two (2) years of third party claims management experience in a computerized hospital/healthcare revenue cycle environment, preferably Epic. With emphasis on application of cash transactions. Banking experience will be considered. Experience should include use of Microsoft Office applications with emphasis on Excel.
Excellent analytical and mathematical skills with a high degree of accuracy. Ability to perform detailed analysis quickly and accurately. Intermediate knowledge of Excel is required. Ability to communicate effectively both written and verbally. Working knowledge of third party insurance carriers and how they are reimbursed is preferred.
Responsible for the timely and accurate application of cash transactions to patient accounts. Responsible for the review of remittances to ensure claims are paid and processed appropriately. Reconciles and balances all transactions to batches and deposits. Traces payments, identifies patients and applies payments to patient accounts and the General Ledger.
Detail oriented individual with the ability to analyze data, and exercise sound judgment. Capable of using problem solving skills and resourcefulness to accomplish many tasks. Balances multiple priorities in a fast paced, high volume environment while adhering to all security policies and complying with stringent audit controls. Ability to deal professionally with the public, other departments, third party payers, and other agencies to resolve complex issues related to the cash posting. Position requires working with a variety of cash documents and items requiring close attention to detail to ensure proper accounting and recording. Processes main deposit for the organization, transfers monies to the General Ledger, maintains records for safekeeping, balances remittances daily to batches in computerized A/R system and reconciles with interfaces.