This position is responsible for the resolution of outstanding and/or denied claims based on third party claim processing rules within established timelines. The Revenue Cycle Associate reports to the central business office supervisor or manager.
Responsibilities:
- Meets goals and objectives in assigned area;
- Complies daily with departmental policies and procedures;
- Performs collection activity to ensure proper resolution and reimbursement on claims;
- Provides thorough, courteous, and professional assistance to coworkers and patients;
- Ensures that all claims are billed and collected and meet all government mandated policies for Integrity and Compliance;
- Collaborates with hospital departments in the resolution of accounts;
- Resolves claims processing issues with third party payers and provides all required information timely; involves patients and family members (where necessary) to ensure timely resolution of claims with insurance companies;
- Resubmits clean and accurate claims to insurance companies in a timely and compliant manner;
- Researches, prepares, and submits appeals to insurance companies;
- Details all actions taken on account with clear and concise notes;
- Monitors and recognizes denials and/or issues that may be trends and escalates to supervisor as needed;
- Maintains strict confidentiality and adheres to all HIPAA guidelines/regulations.
Qualifications:
- Knowledge of basic medical coding/terminology and third-party insurance operating procedures and practices a plus;
- Understands payer guidelines related to effective claim resolution;
- Knowledgeable and proficient with payer websites and other useful resources;
- Knowledge of revenue cycle and/or business office procedures;
- Highly detail-oriented and organized;
- Ability to read, understand, and follow oral and written instructions;
- Ability to establish and maintain effective working relationships and communicate clearly with customers and insurance companies both within and outside of Steward.
About Steward Health Care
Over a decade ago, Steward Health Care System emerged as a different kind of health care company designed to usher in a new era of wellness. One that provides our patients better, more proactive care at a sustainable cost, our providers unrivaled coordination of care, and our communities greater prosperity and stability.
As the country's largest physician-led, minority-owned, integrated health care system, our doctors can be certain that we share their interests and those of their patients. Together we are on a mission to revolutionize the way health care is delivered - creating healthier lives, thriving communities and a better world.
Based in Dallas, Steward currently operates more than 30 hospitals across Arizona, Arkansas, Florida, Louisiana, Massachusetts, Ohio, Pennsylvania, and Texas.
For more information, visit steward.org