Voucher Examiner

FDIHB•Fort Defiance, AZ

About The Position

This position involves following up and corresponding with responsible parties regarding patient accounts in accordance with Center of Medicare & Medicaid Services (CMS) and commercial payer guidelines and requirements. The role includes reviewing delinquent patient accounts, identifying and resolving errors or omissions in documentation, and determining the status of accounts to ensure all efforts have been maximized before adjustments. The Voucher Examiner will review Explanation of Benefits (EOB) and correspondence from third-party payers, update knowledge of payer processes, and meet daily productivity benchmarks set by the Accounts Receivable Manager. This role also requires maintaining internal relationships with other Revenue Cycle Management departments and examining accounts for accuracy, providing adequate documentation to payers within compliance regulations for claim adjudication or reimbursement. The employee may be scheduled for various shifts and holidays, and will perform other duties as assigned.

Requirements

Applicant must have a valid, unrestricted insurable driver’s license.
Resumes and references are required.
Two (2) years’ experience in a healthcare setting in any of the following areas: Patient Registration, Coding, Billing, Collections.
High School Diploma or Equivalency (HSE)

Nice To Haves

Navajo/Indian Preference: Applicants who meet the minimum qualifications for this position and who are enrolled members of the Navajo Nation will be given primary preference in hiring and employment for this position and members of other federally recognized Indian tribes will be given secondary preference. Other candidates will be considered only after all candidates entitled to primary or secondary preference have been fully considered.

Responsibilities

Follows-up and corresponds with responsible parties in accordance to Center of Medicare & Medicaid Services (CMS) and commercial payer guidelines and requirements.
Reviews delinquent patient accounts, following up with responsible parties via telephone and correspondence according to organization policy and procedures.
Identifies errors, omissions, duplications in documentation and works with other departments for resolutions.
Reviews patient accounts to determine the status of the account and ensures all efforts have been maximized and exhausted prior to adjustment process.
Reviews all Explanation of Benefits (EOB) and correspondences from third party payers to identify discrepancies for appropriate follow-up or adjustments.
Updates and maintains all changes in payer processes, requirements and guidelines through self-education.
Meets daily productivity benchmark that is set by the Accounts Receivable Manager.
Upholds internal relationships with other areas of Revenue Cycle Management such as; Patient Registration, Health Information Management, Coding, Patient Accounts and Accounts Receivable.
Examines accounts for accuracy and provides adequate documentation to payers within compliance of regulations for justification of all services rendered for medical treatment to process claims for adjudication or reimbursement.
Performs Other duties as assigned