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Specialist billing and cash app hosp

Company: Cleveland Clinic
Location: Mansfield
Posted on: February 11, 2020

Job Description:

Description:BASIC FUNCTION:Responsible for timely and accurately posting all insurance and patient payments, denials, and refunds for the business office as well as any physician accounts receivable co-mingled claims received. He/she is responsible for ensuring reimbursement received is accurate and makes the necessary contractual adjustments as required by plan reimbursement based on working knowledge of the government, state, and managed care contracts.SUPERVISORY ACCOUNTABILITY: NoneNATURE AND SCOPE:This position interacts with CCIRH finance and accounts payable/IRMA staff, supervisors and management, as well as patients, family members and third-party payers.PRINCIPAL ACCOUNTABILITIES:Supports the mission, vision and values of the hospital.Responsible for working in a safe and protective manner at all times, keeping in mind that safety and environmental hazards are the responsibility of all employees for themselves, other staff members and patients.Accurately posts all insurance payments, denials, contractual adjustments, and take-backs, as well as all patient payments and refunds to each appropriate visit in Paragon/Series and eClinicalWorks, if applicable.Reviews all insurance and third-party payments to ensure accuracy based on contracted fee schedules.Notifies management of unusual inaccuracies/trends in payments by third-party payers.Identifies, prepares and initiates refunds on patient credit balances.Properly posts, balances, and maintains general ledger facility/physician payments and corrections via cash control and a daily spreadsheet.Prepares account transfers between CCIRH patient financial services and Indian River Health Services.Uploads and balances electronic files into Paragon from several vendors/payers including, but not limited to, ePremis, PaySpan, Emdeon, Navinet, Easy Print, BBVA, BCA, CCIRH payroll deductions and Wells Fargo and moves them into designated files on the shared drive.Navigates various websites (Pay Span, Emdeon, Optum Health, Assurant Health and GTL) for explanation of payments, accurately posts payment/denial to Paragon and scans the documents to the appropriate shared drive locations.Initiates secondary/tertiary bill requests in accordance with departmental procedures.Assigns appropriate claim status after payment/refund is posted.Assigns variance claims to appropriate queue for follow up.Maintains multiple bank spreadsheets to assure all deposits and funds received have been applied timely to the accounts receivable.Balances all postings daily in Paragon, Series, and GL.Follows all month-end procedures, inclusive of a complete reconciliation of all bank statements and cash posting spreadsheets.Maintains and clears unidentified account on a monthly basis and reports to management and issues that might arise.Scans all payment remits and denials to shared drive.Posts all hospital paid credit card payments (inclusive of Lifeline) to appropriate system and balances to deposits daily.Receives, processes, balances and deposits all point of service deposits for the hospital campus-wide.Retrieves, posts, and balances all patient portal payments made for CCIRH accounts receivable balances.Receives, researches, and processes all returned refund checks, NSF checks, and bank adjustments related to accounts receivable.Promotes a positive hospital image to physicians, patients, and their families through prompt, accurate, and courteous processing of all accounts.Maintains patient confidentiality of all registration, admission, and financial information.CORE COMPETENCIES:Possess a clear understanding of governmental, commercial, and third-party payers and medical accounting reimbursement methodologies.PC proficiency to include keying and Microsoft Office products.Overall knowledge of business office procedures.Possesses strong understanding of accounting math.Knowledge and clear understanding of HIPAA rules and guidelines.MINIMUM REQUIREMENTS:High School Diploma required; college level course work or degree is preferred.Minimum of two to three (2-3) years of prior payment posting, billing, collections, or admitting experience from either a hospital or doctors office is required.One to three (1-3) years experience with ICD coding diagnosis codes and CPT procedural coding, inpatient or outpatient facility preferred.Previous experience with hospital and medical information systems.CCIRH IS A DRUG AND NICOTINE FREE WORKPLACEThe policy of Cleveland Clinic and its system hospitals (Cleveland Clinic) is to provide equal opportunity to all of our employees and applicants for employment in our tobacco free and drug free environment. All offers of employment are followed by testing for controlled substance and nicotine. Job offers will be rescinded for candidates for employment who test positive for nicotine. Candidates for employment who are impacted by Cleveland Clinics Smoking Policy will be permitted to reapply for open positions after 90 days. Decisions concerning employment, transfers and promotions are made upon the basis of the best qualified candidate without regard to color, race, religion, national origin, age, sex, sexual orientation, marital status, ancestry, status as a disabled or Vietnam era veteran or any other characteristic protected by law. Information provided on this application may be shared with any Cleveland Clinic facility.Cleveland Clinic is pleased to be an equal employment employer: Women/Minorities/Veterans/Individuals with Disabilities

Keywords: Cleveland Clinic, Mansfield , Specialist billing and cash app hosp, Accounting, Auditing , Mansfield, Ohio

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