Patient Financial Services Reimbursement Specialist I - Full Time

Nuvance Health; Danbury (CT); Hybrid; USD 27.000 - 40.000; Vollzeit

Benefits dieser Stelle

PTO

Health/Dental/Vision

401(k)

Zusammenfassung

Nuvance Health in Connecticut seeks a Patient Accounting Specialist to coordinate and monitor all aspects of the Patient Financial Services daily functions, including billing compliance and accounts receivable processes. The role emphasizes accuracy in claims submission, payment application, and denial management.

Required: data entry and customer service experience with at least six months in billing or healthcare settings.

Qualifikationen

• High School diploma or equivalent.
• Data entry and customer service experience required.
• Minimum experience: six months.
• Billing and collections or Medical Office/Healthcare experience preferred.

Aufgaben

• Processes claims, payments, rejections, refunds, and unapplied cash daily.
• Rebill and follow up on delinquent claims.
• Responds to patient and payer inquiries, denials, and correspondence.
• Updates insurance information and informs staff of denials.
• Keeps up with rules and regulations in managed care and state/federal guidelines.
• Adjusts account balances to meet individual account needs.
• Maintains Contract Management reporting and updates information as needed.
• Reviews and resolves patient/insurance credit/debit balances.
• Ensures compliance with policies and procedures.
• Upholds organizational values and attendance.
• Performs other duties as required.
• Collaborates with teams to improve cash flow.

Kenntnisse

Data entry

Customer service

Ausbildung

High School Diploma or Equivalent

Jobbeschreibung

Monday-Friday 8:00am-4:30pm. Hybrid-Remote.

Northwell is the largest not-for-profit health system in the Northeast, serving residents of New York and Connecticut with 28 hospitals, more than 1,000 outpatient facilities, 22,000 nurses and over 20,000 physicians. Northwell cares for more than three million people annually in the New York metro area, including Long Island, the Hudson Valley, Connecticut and beyond, thanks to philanthropic support from our communities. Northwell is New York State’s largest private employer with over 104,000 employees — including members ofNorthwell Health Physician Partners— who are working to change health care for the better.

Summary:

Coordinates and monitors all aspects of Patient Financial Services daily functions, including billing compliance and accounts receivable functions. Responsible for the assigned areas claims submission, payment application, denial management, and account follow-up to ensure optimal reimbursement.

Responsibilities:

• 1. Accurately processes claims, payments, rejections, refunds, credit balances and unapplied cash on a daily basis and performs timely follow-up.
• 2. Confirms electronic and hard-copy billing of any delinquent claims. Rebills and follow-ups of all delinquent claims.
• 3. Responds to all patient and payer inquiries, denials, correspondence and telephone inquiries.
• 4. Advises other areas of updated insurance information and claim denials, i.e., registration.
• 5. Follows through with education of rules and regulations in the managed care system, as well as State & Federal guidelines.
• 6. Adjusts account balances to specific account needs.
• 7. Maintains Contract Management reporting (i.e., payment errors, carve out billings) and updates any information as needed or requested by supervisor.
• 8. Responsible for reviewing and resolving patient/insurance credit/debit balances and ensure proper communication is delivered to the patient.
• 9. Adheres to all policies and procedures related to federal, state and department compliance for the position.
• 10. Maintains and Model the Organizations values.
• 11. Demonstrates regular, reliable and predictable attendance.
• 12. Performs other duties as required.

Education Skills Experience:

Required: High School Graduate or Equivalent.
Required: Data entry. Customer service experience required.

Minimum Experience: six months.

Desired: Experience in billing and collections or Medical Office/Healthcare experience preferred.

Working Conditions:

• Manual: significant manual skills/motor coord & finger dexterity
• Occupational: Little or no potential for occupational risk
• Physical Effort: Sedentary/light effort. May exert up to 10 lbs. force

Company: Nuvance Health
Org Unit: 1785
Department: Patient Accounting
Exempt: No
Salary Range: $19.54 - $29.00 Hourly

Available benefits include: Paid Time Off (PTO); Medical, Dental and Vision Coverage; Health and Dependent Care Flexible Spending Accounts; Health Savings Account; 401(k) Retirement Plan; Basic Life and AD&D insurance; Wellness Programs; Employee Assistance Program; and Team Member Discounts. Available benefits for union positions may vary in accordance with applicable Collective Bargaining Agreements.