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Administrative/Clerical
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2020-R0285066 Requisition #
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JOB SUMMARY / PURPOSE

This job is responsible for payment posting functions including, entering patient and insurance payments, contractual allowances and other adjustments onto the patient’s account and interpretation of Explanations of Benefits (EOBs)/Electronic Remittance Advice (ERAs) from insurance.
Work requires an understanding of detailed billing requirements, cash posting processes and government/commercial insurance reimbursement terms, remittance advice details and contractual/other adjustments. Attention to detail, the ability to accurately and timely troubleshoot/resolve (within position scope) issues that have a potential impact on revenues are also required.

KEY JOB RESPONSIBILITIES


1. Reviews and posts payments and write-off/adjustments from insurance and patients.
2. Reviews Explanation of Benefits (EOBs)/ Electronic Remittance Advice (ERAs), payments, adjustments, insurance contracts and contracting system, insurance benefits, and all account comments; applies knowledge of payer contracts and experience with insurance reviews to gather additional information as necessary.
3. Posts and tracks electronic funds transfer (EFT) information and validates EFTs for accuracy.
4. Follows write-off approval protocols for non-routine adjustments.
5. Manually posts non-electronic activities to include: payments, adjustments, and zero payment denials.
6. Completes daily posting log and quarterly cash handling audits and reports findings to Supervisor/Manager.
7. Identifies and researches unusual, complex or escalated issues as assigned; applies problem-solving and critical thinking skills as necessary to resolve issues within the scope of position authority or to escalate following established procedures.
8. Notifies Supervisor/Manager of ongoing issues and concerns as appropriate
9. Documents all activities and findings in accordance with established policies and procedures; ensures the integrity of all account documentation; maintains confidentiality of medical records.
10. Meets quality assurance and productivity standards for timely and accurate posting of payments in accordance with organizational policies and procedures.
11. Applies current knowledge of detailed billing requirements and cash posting processes.
12. Applies current knowledge of government/commercial insurance reimbursement terms, contractual and/or other adjustments and remittance advice details.
13. Depending on role and practice management training, may be called upon to support other areas in the Revenue Cycle.

MINIMUM QUALIFICATIONS

Required Education
Does Not Apply

Required Licensure and Certifications
Does Not Apply

Required Minimum Knowledge, Skills and Abilities
• Knowledge of debits and credits, including how to interpret/process electronic remittance advices.
• Knowledge of medical insurance, payer contract, CPT and ICD codes.
• Ability to understand and apply government/commercial insurance reimbursement terms, contractual and/or other adjustments and remittance advice details.
• Ability to enter data in accordance with established standards of timeliness, accuracy and productivity.
• Ability to troubleshoot, understand and/or adapt moderately complex oral and or written instructions/guidelines to diverse or dissimilar situations.
• Ability to maintain confidentiality of medical records, and to use discretion with confidential data and sensitive information.
• Ability to demonstrate attention to detail and critical thinking skills within the context of the assigned function, with a commitment to accuracy.
• Ability to effectively prioritize and execute tasks while under pressure.
• Ability to demonstrate excellent customer service skills, including professional telephone interactions.
• Ability to read, understand and communicate in English sufficient to perform the duties of the position.
• Ability to establish and maintain effective working relationships as required by the duties of the position.
• Ability to use office equipment and automated systems/applications/software at an acceptable level of proficiency.

About Us


CHI Memorial is a not-for-profit, faith-based healthcare organization dedicated to the healing ministry of the Church. Founded by the Sisters of Charity of Nazareth and strengthened as part of Catholic Health Initiatives, it offers a continuum of care including preventative, primary and acute hospital care, as well as cancer and cardiac care, orthopedic and rehabilitation services. CHI Memorial is a regional referral center of choice with 3,400 associates and more than 700 affiliated physicians providing health care throughout Southeast Tennessee and North Georgia.

Equal Opportunity Employment


Consistent with our Core Values, Catholic Health Initiatives employers are EEO/AA/M/F/Vets/Disabled Employers. Qualified applications will receive consideration for employment without regard to their race, color, religion, national origin, sex, sexual orientation, gender identification, protected veteran status, disability or any other legally protected characteristic

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