QUALIFICATIONS Education • High school graduate or equivalent Experience/Skills • Athena experience preferred • Possesses knowledge of business office operations • Understands third party billing requirements • Understands Medicare/Medicaid inpatient and outpatient billing • Strives for customer satisfaction when responding to all patient/customer inquires (internal customers) • Experience using office equipment • Adapts professionally to changes in procedures and/or workload • Possesses excellent written and oral communication skills • Works independently with little supervision • Maintains concentration • Remains committed to a “cross training” philosophy for all assigned tasks Working Conditions • Works in a well-ventilated, well-lit general office environment • Works well under pressure with attention to time constraints ROUTINE RESPONSIBILITIES Behavioral Expectations • Consistently complies with established Behavioral Expectations Essential Duties • Reviews, identifies, and corrects claims issues identified in inhouse hold and the claim scrubbing holds • Sends clean, timely claims out on first billing • Works reconciliation desktops to ensure upfront rejection of claims are processed and resubmitted to correct payer • Reviews assigned outstanding accounts receivable by using ATB, queues, and payment reports • Submits timely and accurate adjustments documenting activity in account • Understands and manages denials, submitting timely disputes and appeals • Follows up with insurance companies to ensure claims are processed and paid correctly according to contract • Understands payor contracts and billing guidelines. revenue codes, cpt codes, modifiers, and payor-specific guidelines • Investigates and reports claims denial trends with payer documentation for departments to review and establish action plan • Provides back-up phone support to billing lines daily Full time/Day shift 80 hours/Biweekly