Collections & Denials Management Representative
Rochester Regional Health

Description

HOW WE CARE FOR YOU

At St. Lawrence Health, we are dedicated to getting health care right. Our robust benefits and total rewards foster employee wellbeing, professional development and personal growth. We care for your career while caring for the community.

• Medical, dental, vision, hearing benefits
  
• Paid vacation & holiday pay
  
• Same Day pay through Daily Pay
  

SUMMARY

The C & D specialist is responsible for reviewing accounts which have been denied or underpaid by third party payers and to resolve the issues resulting in denial/underpayment and to formally appeal. The specialist will conduct comprehensive reviews of clinical documentation to determine if an appeal is warranted. Should an appeal be necessary, the specialist will write compelling and factual arguments which will then be sent to the insurance carrier. The specialist will work across departments to gather the appropriate documentation and information for a clear and concise appeal. Responsibilities will include basic knowledge of medical billing, medical claims processing and accounts receivable collections. The Medical collection specialist must have the Ability to learn and understand medical billing protocol and reimbursement issues, work within Meditech and Emdeon to identify denial trends as well as be responsible for locating and monitoring overdue third party accounts preventing write off. Must be comfortable working tight deadlines, have the ability to analyze and trouble shoot billing concerns and communicate concerns with management.

Canton-Potsdam Hospital is a warm and caring not-for-profit community healthcare facility that's certified for 94 beds. Our mission is to provide exceptional healthcare services to the community. Within our welcoming walls, you'll find a wide array of core programs in emergency medicine, acute care, hospitalist medicine, and critical care. But that's just the beginning. We're not just a hospital; we're a beacon of health and wellness in the North Country. We proudly offer outpatient health services in Brasher Falls, Canton, Colton, Gouverneur, Massena, Norfolk, and Potsdam, NY.

STATUS: Full-time

LOCATION: SeaComm

DEPARTMENT: Patient Accounting

SCHEDULE: 7.5-hour day shift

ATTRIBUTES

• Required: High school diploma
  
• Required: 1-2 years in accounts receivable experience OR 1 year in a healthcare setting.
  
• Preferred: Bachelor's degree in related field
  
• Preferred: AHIMA Certified & Medical Billing Certification - AAPC Certified Professional Biller (CPB)
  
• Preferred: 3 years of Medical office or denial management experience
  

RESPONSIBILITIES

• Creating and navigating Meditech work lists
  
• Compiling appeal letters to send to insurance providers
  
• Performing consistent follow-up on pending appeals and responding to payors regarding billing issues and insurance problems
  
• Performing Customer Service related actions
  
• Abiding by productivity standards set by business office leadership
  
• Reading and understanding patient medical records and ensuring HIPAA confidentiality
  

PHYSICAL REQUIREMENTS: S - Sedentary Work - Exerting up to 10 pounds of force occasionally Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.

PAY RANGE: $18.90 - $27.43

The listed base pay range is a good faith representation of current potential base pay for successful applicants. It may be modified in the future. Pay is determined by factors including experience, relevant qualifications, specialty, internal equity, location, and contracts.

Rochester Regional Health is an Equal Opportunity / Affirmative Action Employer. Minority/Female/Disability/Veteran

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