Professional Billing Specialist, Anesthesia

🕒 Maio 29

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Shriners Children's

SiteLinkedInTodas as Vagas

10.000+ funcionários

Fundada em 1922

⚕️ Seguro de Saúde

🤝 Sem Fins Lucrativos

🔬 Ciência

Healthcare Insurance • Non-profit • Science

A Shriners Children's é uma organização sem fins lucrativos que oferece cuidados pediátricos especializados há mais de 100 anos. Com um compromisso com a excelência, sua equipe compassiva de médicos e enfermeiros foca em fornecer atendimento personalizado em várias especialidades, incluindo cuidados para queimaduras, ortopedia e reabilitação pediátrica. Eles também se envolvem em pesquisas inovadoras destinadas a melhorar os tratamentos médicos e a qualidade de vida das crianças.

Descrição

• Managing all professional billing requirements • Managing accounts receivable tasks according to standard and productivity measurements. • Ensuring all regulatory and payor guidelines are followed. • Coordinating payor denial and appeal follow up activities to ensure timely response from third party payors. • Processing all payor denials, documentation requests and appeals. • Reviewing all denial accounts for categorization and special requirements for initiating appeals. • Communicating global payer issues with the payer relations team. • Assisting with monitoring of the day-to-day activities related to appeal follow up and denials. • Maintaining the healthcare tracking tool/application. • Monitoring all Claim Edit and Denial Management work queues and lists. • Ensuring medical records requests are completed and submitted within 48 hours. • Tracking all denials on a database to determine the outcome. • Collecting/analyzing, report status, metrics and trends of activity. • Distributing reports on a routine basis to specific distribution group. • Organizing all data and activity in a retrievable way.

🎯 Requisitos

• Epic PB Resolute experience • 3 years of related Anesthesia experience • 5 years' experience in a Healthcare/Hospital Revenue Cycle Environment including Third Party Collection/AR Receivables • Healthcare Revenue Cycle revenue management • EDI Transaction sets including 837P • Knowledge of insurance contract rates and terms • Understanding of Registration and Collections • Understanding of Government and Managed Care billing, coverage and payment rules • Ability to comprehend payor 835 and paper EOB responses • Understanding of CCI edits, CPT, HCPCS, ICD-10 and Revenue Codes • Intermediate Excel skills • Excellent computer skills, especially spreadsheet and database applications. • Knowledge of managed care patient financial systems and of the specific billing and payment standards utilized for services provided within a hospital setting. • Thorough understanding of managed care payment methodologies and the principles of managed care. • Certification in Epic PB Resolute - or agree to obtain certification within 12 months after hire • Bachelor’s Degree or equivalent combination of education and experience

🏖️ Benefícios

• All employees are eligible for medical coverage on their first day! • Eligible for a 403(b) and Roth 403 (b) Retirement Saving Plan with matching contributions of up to 6% after one year of service. • Paid time off • Life insurance • Short term and long-term disability • Flexible Spending Account (FSA) plans • Health Savings Account (HSA) if a High Deductible Health Plan (HDHP) is elected. • Additional benefits include tuition reimbursement • Home & auto insurance • Hospitalization • Critical illness insurance • Pet insurance • Employee and dependents coverage in accordance with the plans.