Claims Editor

St. Joseph's/Candler; Savannah (GA); Sur place; USD 45 000 - 60 000; Plein temps

Résumé du poste

St. Joseph's/Candler in Savannah, GA seeks a Claims Editor to review and resolve insurance claim edits and rejections from Meditech and SSI, ensuring compliance with federal and state regulations and timely billing.

The role involves analyzing edit reports, identifying error sources, and proposing process improvements in Patient Accounts. Responsibilities include editing, rebilling when needed, and collaborating across departments to maintain positive cash flow and adherence to billing rules.

Qualifications

• 2-3 years experience in healthcare claims and reimbursement.
• Knowledge of Meditech and SSI systems.
• Understanding of billing regulations and guidelines.

Responsabilités

• Performs claims editing to ensure a positive cash flow. Accurately screens and processes assigned claims edits and rejections. Meets departmental time standards for corrections. Rebills claims when appropriate.
• Provides oversight of claims editing. Reviews and analyzes claims editing reports. Determines the source of errors and rejections. Recommends process changes within Patient Accounts and other departments to ensure efficiency and compliance.
• Creates SSR inquiries to SSI for creation of edits for more efficient workflow.
• Works collaboratively with others to achieve efficiency and accuracy. Seeks answers/assistance from the appropriate source. Keeps up to date on billing/compliance rule changes

Connaissances

Healthcare claims

Reimbursement processes

Billing knowledge

Formation

High School Diploma

Description du poste

The Claims Editor is responsible to ensure all insurance claim edits and or rejections from Meditech and SSI are reviewed, analyzed and resolved. Ensure that the claims are compliant with federal and state regulations. Responsibilities include but are not limited to billing, prompt adding and follow-up of SSI tickets to enhance billing efficencies.Understands the laws that govern the billing.

Education

• High School Diploma - Preferred

Experience

• 2-3 Years Healthcare claims and Reimbursement - Required

License & Certification

• None Required

Core Job Functions

• Performs claims editing to ensure a positive cash flow. Accurately screens and processes assigned claims edits and rejections. Meets departmental time standards for corrections. Rebills claims when appropriate.
• Provides oversight of claims editing. Reviews and analyzes claims editing reports. Determines the source of errors and rejections. Recommends process changes within Patient Accounts and other departments to ensure efficiency and compliance.
• Creates SSR inquiries to SSI for creation of edits for more efficient workflow.
• Works collaboratively with others to achieve efficiency and accuracy. Seeks answers/assistance from the appropriate source. Keeps up to date on billing/compliance rule changes