Reimbursement Specialist / Analyst

UHS•Richmond, VA

16h

About The Position

The Atlantic Region Central Billing Office (“ARCBO”) or (“CBO”) provides business office services including billing, collections, cash posting, pre-access management, variance, and customer service to our affiliated Universal Health Services hospitals. The Atlantic Region CBO is seeking a dynamic and talented Reimbursement Specialist / Analyst. The Reimbusement Specialist / Analyst is responsible for the resolution of accounts entered into the Audit, Denial and Accounts Receivable Systems.

Requirements

High school diploma or equivalent
1-3 years healthcare experience preferred
Strong Microsoft Office skills (Excel, Word, Outlook)
Customer focused both internally and externally
Strong attention to detail
Ability to multi-task
Strong 10 key data entry
Excellent written and oral communication skills
Familiarity and 1-3 years healthcare business office experience preferred

Responsibilities

Ensure a complete and transparent reporting of outcomes resulting from subsequent follow up including audits.
Effectively track, trend, and assure quality of all accounts by ensuring they are properly entered and tracked in all systems.
Enter and follow up on audit accounts that are received by the CBO.
Comprehend audit requests and select appropriate audit type.
Understand financial information for the account.
As the audit progresses through the process, complete the updates and determine how to proceed with accounts that require action.
Follow up with payers on all tasks that are due.
Work with payers and facilities to obtain decision letters, and additional information as required.
Document in patient account notes as indicated.
Work with Appeals staff for resolution on denied accounts.
Responsible for routing appeals relating to technical and clinical issues identified during the billing of claims, denial or receipt of audit.
Works with HIM, vendors and facility clinicians to correct deficiencies in a timely manner.
Identify problem accounts and trends.
Escalate as appropriate.
Works with insurance companies to secure payment on account balances outstanding.
Properly documents the patient account with actions taken to resolve issue.
Meet productivity standards and departmental goals and objectives.
Other duties as assigned.