Job Number 64721
Posted 7/15/2019
Account Northern Light AR Gould Hospital
Department Patient Accounting ARG
Location |ME| TAMC - North Street Mall Pat, ME 04769
Schedule Regular Full-time
Shift Day
Hours 0800-1630
Job Details The Patient Accounting Specialist reviews and updates third party claims (UB04 and CMS 1500). Claims may then be transmitted electronically or submitted on hard copy, depending on third party payer capability. Follow-up, third party appeals and correspondence requirements will vary depending up on the financial class of the assigned accounts. Technical performance will be based on the degree of adherence to third party billing, follow-up, denials management, and contract management needs, quality reviewed and productivity standards. Some billing assignments may require Excel spreadsheet experience in order to prepare third party logs and special reports. The employee will be challenged to think, judge and set priorities independently with minimal supervision. Multiple computer software systems and applications will be utilized to complete daily tasks.

1. Daily follow up of actionable Craneware Denials assigned to a user's worklists either by import or direct assignment from another group or their supervisor. (To include but not limited to)
a. Calls to payers as needed.
b. Emails to payers as needed.
c. Payer website access and processing of denials through such websites.

2. Appeals as needed, examples are Medicare second level appeals.

3. Account questions/follow up as requested.

4. Escalation of accounts to manager/team lead/analyst as needed for account follow up.

5. Sharing/Escalation of denial trends to manager/team lead/analysts as they relate to incoming denials to workflows.

6. Meetings as required.

7. Assistance with denial analytics as needed.

8. Perform other duties as assigned

High School Diploma with a higher education preferred. Previous healthcare billing experience preferred but will provide technical training to qualified applicants.

Equal Opportunity Employment
We are an equal opportunity, affirmative action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, age, disability status, gender, sexual orientation, ancestry, protected veteran status, national origin, genetic information or any other legally protected status.

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