Patient Financial Service Representative - Reimbursement & Reconciliation
Atlantic Health (SP)
Required Education: High School
Admin / Clerical
Internal Number: 106969304
Atlantic Health System is seeking a full-time Patient Financial Srv Rep. for PFS Reimbursement to cover Day Shifts (Corporate Building South Street, Morristown NJ)
Responsible for ensuring that unpaid and partially paid claims are resolved in an efficient and timely manner. Resolves EOB discrepancies and researches refunds.
Monitors and ensures that collections, net, gross and days in accounts receivable targets are met.
Follows up on submitted claims, monitors unpaid claims and resubmits claims with appropriate corrections and documentation.
Works declines, and processes appeals.
Ensures that established billing targets for collections, gross, days in A/R and net collection ratios are met.
May analyze claims system reports to ensure that underpayments are correctly identified and collected from key carriers.
Works with payer and provider representatives to negotiate higher rates for claim payments.
Responds to patient and third-party inquiries, researches and resolves complex claims and corrects errors.
Reviews correspondence and rejection data from insurance carriers; posts rejections and performs reconciliations.
May transfer secondary balances to appropriate financial class and provide documentation for processing the claims.
Reviews Credit Letter Sent (CLS) and transfers balance to appropriate financial class and dunning level.
May process refunds for supervisory approval.
Maintains strictest confidentiality; adheres to all HIPAA and Federal Payor guidelines and regulations.
Meets the daily productivity call and accounts.
Performs other related duties.
College degree required
Familiarity with ICD9, ICD-10, preferred, CPT codes and DRG's. Ability to analyze a UB04 and Explanation of Benefits. Computer Skills: Must be proficient in Microsoft Outlook, Work and Excel. EPIC knowledge a plus. Prior Office / Call center preferred
Atlantic Health System aims to deliver the highest quality, safety and care combined with the best experience for our patients and their families. We are confident that you will find success within Atlantic Health System, which has been named for the 14th year in a row to Fortune's 'Top 100 Best U.S. Companies to Work For' list. We believe you will find that our culture of collaboration and care exemplifies the value we place on our patients, their families, and our employees.
Atlantic Health System, Inc. is an equal employment opportunity employer and federal contractor or subcontractor and, therefore, abides by applicable laws to protect applicants and employees from discrimination in hiring, promotion, discharge, pay, fringe benefits, job training, classification, referral, and other aspects of employment. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, pregnancy, gender identity or expression, sexual or affectional orientation, national origin or nationality, citizenship status, disability, age, genetics, protected veteran status, ancestry, marital status.