About The Position

CBO Billing Financial Analyst performs various interviewing, fact collection and financial evaluation tasks in connection with credit and collection in a large and diversified hospital serving both non-indigent and indigent patients qualifying for various types of specialized assistance programs. Incumbents may specialize in either credit or collection work or a combination of both. Primary emphasis is on financial counseling with patient from pre-admission through account becoming a discharged zero balance. Incumbents are responsible for interview of patient, family or guarantor to explain charges, hospital policy and payment procedures.

Requirements

  • Generally requires 3 to 5 years of related experience.
  • High school diploma is required.
  • Ability to analyze, organize and prioritize work accurately while meeting multiple deadlines.
  • Ability to communicate effectively in both oral and written form.
  • Ability to handle difficult and stressful situations with critical thinking and professional composure.
  • Ability to understand and follow instructions.
  • Knowledge and skill in use of job appropriate technology and software applications.
  • Valid license or certification is required as needed, based on the job or specialty.

Nice To Haves

  • Bachelor's degree in related field is strongly preferred.

Responsibilities

  • Identify and resolve accounts through the use of existing Patient Accounting Systems.
  • Runs billing edit reports of claim processing, holds, errors as requested.
  • Receives and processes requests from third parties for additional information (i.e.: medical records, charge explanations and accident details).
  • Maintains files for future reference. Updates JHS Patient Accounting System with any changes to financial class, insurance eligibility, etc. based on new or updated information.
  • Reviews claims for accuracy, performs required edits, and submits claims and rebills to payors daily in paper and/or electronic format to ensure accurate and timely filing of claims and prompt payment.
  • Investigates and corrects the billing edits for physician license number and billing documentation, in order to expedite payment process.
  • Works claims on hold and/or notifies Medical Records of approaching filing deadlines to ensure all efforts are made to file the claim before the filing deadline.
  • Research and document all billing activity and post comments into the JHS Patient Accounting System.
  • Coordinates medical record request as needed.
  • Accurately document work activity on-line for future departmental reference.
  • All documentation should be clear, concise and easily understood by others.
  • Basic understanding of medical terminology/HCPC coding and how it relates to patient medical service.
  • Understanding of National billing codes (UB04) and the Payor requirements for these codes .
  • Works with supervision, management and the patient accounting staff to improve processes, increase accuracy, create efficiencies and achieve the overall goals of the department.
  • Maintains productivity and quality standards in accordance with department policy and procedure.
  • Informs the Supervisor of any problems or changes in Payor requirements.
  • Exercises independent judgment to analyze and report repetitive edit failures so corrective actions can be taken.
  • Maintains knowledge of applicable rules, regulations, policies, laws, and guidelines that impact billing.
  • Attends scheduled department meetings and training sessions.
  • Must be very detail-oriented and accustomed to high volume output.
  • Demonstrates behaviors of service excellence and CARE values (Compassion, Accountability, Respect and Expertise).
  • Performs other job duties that may be required to provide the quality and level of service expected by JHS and Revenue Cycle management.
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