HOURLY RATE (DEPENDING ON SKILLS/EXPERIENCE): $22.14 - $29.82
SCOPE: Responsible for review of EOBs, posting and managing account payments both in EPIC and Pharmaserv. Audit posted work to insure accuracy, appropriate reassignment of patient or secondary balances. Responsible for reviewing and making adjustments as needed in Epic WQs (credit), distribute monies as appropriate. Help to identify issues and report to supervisor/manager; for potential workflow improvement, EPIC rules to built or edited, etc.
Responsibilities
RESPONSIBILITIES:
- Review automated payment/adjustments and/or post line item payments and adjustments from manual EOBs to patient accounts, and reconcile / adjudicate fee schedule variances with approved variance adjustments.
- Provide information to RCPAYRSUP/RCMGR to allow the research, re-bill, and/or appeals denied/incorrectly/inconsistently paid claims.
- Identifies consistency in fee schedule allowable differences and communicates up-line for updating.
- Analyze credits on accounts via credit WQs to determine if refunds should be processed, erroneous and need corrections or distribute monies.
- Pull daily bank activity for both EPIC and Pharmaserv (DBAs/Lockbox)
- Perform other various duties/projects as assigned
Qualifications
MINIMUM QUALIFICATIONS:
- GED / Diploma required
- 2 Years Business Admin / Healthcare / Related Field preferred
- Certified Medical Reimbursement Specialist CMRS preferred
- Certified Medical Insurance Specialist CMIS preferred
- 1 year Billing in Medical Office / Hospital required
- 6 months EMR preferred
PHYSICAL DEMANDS:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations will be offered to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to sit and use hands to manipulate a computer keyboard and mouse. The employee is occasionally required to stand, walk, and reach with hands and arms. The employee must occasionally lift and/or move up to 30 pounds. Requires vision and hearing corrected to normal ranges.
WORK ENVIRONMENT:
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations will be offered to enable individuals with disabilities to perform the essential functions. Work is performed in an office environment. Involves frequent contact with staff. While performing the duties of this job, the employee is regularly exposed to direct contact with patients with potential for exposure to blood, toxic substances, ionizing radiation and other conditions common to a clinic environment.
