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.
Handles a high volume of third party claims and ensures that accurate information is submitted to payers via the clearing house and/or payer intermediary in a timely manner to ensure prompt payment. Initiates the actions necessary to correct problems that prevent claims submission and/or contacts the individuals that are responsible for taking the corrective action to expedite claims processing. Documents all follow up activities on accounts in a clear and concise manner. Identifies and reports the trends of claim edits and rejections to the supervisor for further review. Performs a variety of duties necessary to resolve individual inpatient and outpatient balances. Keeps abreast of the changes to federal, state, and insurance regulations as well as maintains a general knowledge of billing and payment methodologies/guidelines. Has an understanding of the Revenue Cycle and how it functions. Performs all other duties as requested by supervisor.
High school diploma required. Associate Degree in business related field preferred.
One (1) to two (2) years of third party claims management and/or billing experience in a computerized hospital/healthcare revenue cycle environment preferably Epic.
NY Medicaid experience is required
Extensive knowledge of third party insurance carriers and their billing and reimbursement requirements. Excellent analytical and organizational skills. Demonstrated ability to perform detailed analysis quickly and accurately in a high volume, fast paced environment. Ability to communicate effectively both written and verbally. Microsoft Office skills preferred. Proven ability to effectively navigate various payer websites and other web based applications.