This position is responsible for the review and follow-up on accounts to ensure timely payment from insurance or patients for CGH and ECLN accounts.

Essential Functions:

• Investigate and resolve denied claims and complete documentation requests according to payer and department guidelines. Prepare electronic and or paper claims.
• Review claims and resolve any missing or inaccurate information with insurance company and or patient.
• Read and understand Explanation of Benefits from various insurance companies.
• Communicate with insurance companies via phone or online tools for claim resolution.
• Review and navigate online payer platform websites and clearinghouse portal as appropriate.
• Maintain assigned AR Work Queues at a reasonable age-base date.
• Identify denial trends and works with leadership to resolve.
• Process daily AR related mail, resolve any issues and scan batches.
• Thoroughly document patient account in the billing software.
• Identify patient and insurance refunds and process timely and accurately.
• Assist patients with questions regarding statements or other information.
• Collect payments from patients via phone and assist patients in setting up payment plans as appropriate.
• Adapt to updates and changes in professional billing system/HER system.
• Maintain confidentiality.
• Keep current with healthcare trends and practices.
• Reports any issues and concerns to manager to ensure quality patient service.
• Attend departmental and company-wide meetings as requested.
• Perform other duties as assigned.

Education: High School Diploma or equivalent preferred.

Experience: A minimum of one to two (1-2) years accounts receivable experience, within a healthcare organization. Employment within a health insurance company with similar duties may be substituted. Previous experience with EPIC is preferred.

Qualifications (Knowledge, Skills, and Abilities): The job holder must demonstrate current competencies applicable to job position including but not limited to:

• Knowledge of computer systems, programs, and applications and general office duties.
• Knowledge of medical Coding: CPT, ICD-10, modifiers and medical terminology.
• Knowledge of medical billing/collection practices.
• Knowledge of HIPAA guidelines.
• Ability to communicate effectively and professionally in verbal and written form.

To apply, email your resume to hr@charlottegastro.com.