How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives. Work Shift Day (United States of America) Duties and Responsibilities * Collect and resolve payments from insurance companies by working with assigned payers and utlizing Policies and Procedures. * Execute the denial appeals process, which includes receiving, assessing, documenting, tracking, responding to, and/or resolving appeals with third-party payers in a timely manner. Research and resolve payer rejected/denied claims and analyze accounts for insurance payment accuracy/completeness and for payer claim processing accuracy per contract. Work with clinical staff as needed to follow-up and appeal denials. * Prepare, maintain, assist with, and submit reports as required. * Appropriately report on-going problems specific to health system departments, and/or contracts to Team Manager or Team Lead. * Provide feedback and process improvement ideas to management regarding facility, Patient Access, Case Management, HIM, Billing and/or payer issues identified when reviewing accounts for resolution. * Appeal in accordance with methodology in departmental policy and procedure including using correct grammar and spelling. * Identify contract issues related to denials and delayed adjudication; communicate those issues to Manager. * Transmit required documentation to Government and third-party payers for the purpose of resolving payments. * Ensure all payer contact is fully documented in the appropriate software application. * Ensure claims are crossed over to secondary insurances, reporting any delay in unbilled secondary claims to your Lead. * Consistently meet the current productivity standards in addressing and resolving accounts. * Consistently meet the current quality standards in taking appropriate actions to identify and track root causes, successfully appeal denied accounts, and trend issues. • Teamwork * Provide individual contribution to the overall team effort of achieving the department AR goal * Identify opportunities for system and process improvement and submit in team meetings * Become cross-trained and fill in for other staff as assigned * Particpate and encourage team collaboration and unity. * Initiate communication with peers about changes and procedures, convey new relevant information to other team members and management. • Administrative * Professional Communication * Assure patient privacy and confidentiality as appropriate or required * Communicate in a professional manner with patients, their families and representatives from third party payor organizations, physicians and their staff, co-workers and management. * Maintain professional relationships and convey relevant information to other members of the healthcare team within the facility and any applicable referral agencies * Interact with internal customers including HIM, Revenue Integrity, Patient Access, and the SBO in a professional manner to achieve revenue cycle department AR goals and objectives * Department Methods/Procedures/Operations * Follow department guidelines for lunch, breaks, requesting time off, and shift assignments * Operate office equipment and machinery and utilizes ergonomic workstations, equipment, and supplies * Follow JCAHO and outside regulatory agencies’ mandated rules and procedures * Utilize assigned menus and pathways in the mainframe system. Report software application problems to the appropriate source. * Utilize assigned computer hardware. Report hardware problems to the appropriate source. * Participate in the testing for assigned software applications, including verification of field integrity when needed. * Perform other duties and responsibilities as assigned Qualifications Required Minimum Education High school diploma Required or equivalent Required Required Minimum Experience Minimum 2 years collection experience Preferred Required Minimum Skills Ability to perform mathematical calculations with High-level problem solving, analytical, and investigational skills • Excellent communication skills when dealing with patients, families, public, co-workers, and professional offices including oral and written comprehension and expression • Basic experience and knowledge of PC applications • Detail-oriented, good organizational skills, and ability to be self-directed • Strong time management skills; Ability to learn quickly and meet continuous timelines, managing multiple priorities and a heavy workload in a high-stress atmosphere • Demonstrate flexibility to perform other tasks as needed in an active work environment with changing work needs • Ability and willingness to exhibit behaviors consistent with principles of excellent service • Ability and willingness to demonstrate and maintain competency as required for job title and the unit/area(s) of assignment • Ability and willingness to exhibit behaviors consistent with standards of performance improvement and organizational values (e.g., efficiency & financial responsibility, safety, partnership & service, teamwork, compassion, integrity, and trust & respect) Join us and discover the support to do more meaningful work—and enjoy a more rewarding life. Connect with the most integrated health system in Georgia, and start a future that gives you more.