Service Representative at Inova Health System in Cincinnati, OH

📌 Cincinnati 🏷️ Other 🕑 2021-08-03
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Patient Financial Service Representative 4 (remote)

Job Description.
Able to perform the duties for a PSR III and responsible for the timely and accurate editing, submission, and/or follow-up of assigned claims. Able to process claims for multiple payer types (Commercial, Managed Care, Blue Cross, Medicare, Medicaid, etc.). Assure all assigned claims meet clearinghouse and/or payer processing criteria. Assure appropriate follow-up on assigned work lists. All work meets departmental productivity and quality review standards. Provide Team Supervisor or Manager with issues and potential resolutions regarding problems with the claims process. Assure appropriate and timely documentation of all account activity. Correspondence is handled appropriately. Payer response reports and rejection reports are worked timely and meet Departmental Productivity and Quality Review standards. Provide support, education, and guidance to Team. Perform duties, as assigned, in the absence of the Supervisor or Manager.
WIP counts completed timely. All required reports are filed timely and accurately. Job Responsibilities.
Able to perform the duties for a PSR III and responsible for the timely and accurate editing, submission, and/or follow-up of assigned claims. Able to process claims for multiple payer types (Commercial, Managed Care, Blue Cross, Medicare, Medicaid, etc.).Assure all assigned claims meet clearinghouse and/or payer processing criteria. Assure appropriate follow-up on assigned work lists. All work meets departmental productivity and quality review standards. Provide Team Management with issues regarding claims follow-up process. Provide Team Supervisor or Manager with issues and potential resolutions regarding problems with the claims process. All clean claims should be submitted the day they are received and submitted via the appropriate medium (paper vs. electronic) and with all required attachments. Claims are reviewed, corrections identified, and corrections made or resolution initiated within 24 hours of the date the claim was received. Provide support the team members as needed. Handles most complex and/or highest dollar accounts and provides appropriate follow-up based on established protocol or SRGs. Productivity and quality expectations met weekly for assigned work lists and any supervisor assigned special tasks. Provide support to team members as needed. Provide resolution for pended (WIP backlog) claims within allowable time frames (as defined for appropriate deficiency) - able to resolve complex issues either through individual actions or by coordinating information/action of other team members, other Patient Accounts staff or the appropriate individuals in other Hospital Departments or at the payer. Seeks assistance from Supervisor appropriately. Write-off requests are completed correctly and submitted daily for Supervisor review. Document and report claims submission issues immediately and provide feedback to Team management regarding the issues and wins. Assure appropriate and timely documentation of all account activity. Correspondence is handled appropriately. All correspondence is handled appropriately and with 48 hours of receipt or within the customer's expectations. Document activity in Health.
Quest and TRAC. Assure documentation is professional, appropriate and accurately depicts actions performed and is in accordance with Departmental Quality Review Standards. Payer response reports and rejection reports are worked timely and meet Departmental Productivity and Quality Review standards. Maintain knowledge of payer requirements, UB-92 standards, and system (Hospital, clearinghouse, payer) functionality, and Hospital policy and procedure. All issues are resolved or resolutions initiated within 24 hours. Identify issues with payer rejections, provide feedback regarding rejections to Team Management. Take direction from Supervisor or Manager to resolve issues. Provide support, education, and guidance to Team. Perform duties, as assigned, in the absence of the Supervisor or Manager. Identify the need for and provide support and guidance to other Team members to assure all Team members are efficient and productive. Perform other duties, as assigned, by the Supervisor or Manager. Serve in the place of the Team Supervisor or Manager in their absence.
WIP counts completed timely. All required reports are filed timely and accurately. All daily, weekly, monthly reports are completed and submitted timely at least 80% of the time and reports are completed with minimal errors. Weekly WIP counts completed timely. Shift Hours: 2:30pm
- 6:30pm M-FEducation.
Additional

Requirements

AA degree or additional three years experience appropriate to the position under consideration.

Experience

Three year of experience, Three years. Experience in revenue cycle, finance, customer service, or data analytics.
CertificationCPAT certification within one year of start date.

Skills

Working keyboard skills. Knowledge of Microsoft Word and Excel. Working knowledge of Microsoft Office products. Ability to think critically to identify trends and resolve accounts independently. Working knowledge of Patient Accounting system(s)About UsInova is Northern Virginia s leading nonprofit healthcare provider. Our mission is to provide world-class healthcare every time, every touch to each person in every community we have the privilege to serve. Inova s 18,000 team members serve more than 2 million individuals annually through an integrated network of hospitals, primary and specialty care practices, emergency and urgent care centers, outpatient services and destination institutes. Safety Always: Learn how we keep our team members and patients Safe@Inova.

View Application

You will be redirected to Inova Health System's preferred application process.

You will be redirected to Inova Health System's preferred application process.

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