About the role
Be inspired. Be valued. Belong.
At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide: Comprehensive health benefits that start day 1 Student Loan Repayment Assistance & Reimbursement Programs Family-focused benefits Wellness incentives Ongoing mentorship, development, leadership programs...and more Description
Assist with departmental workflow as needed. Identifies and notifies leadership of issues and initiates appropriate action for resolution. Serves as point person for employee questions.
Maintains thorough understanding of insurance, registration, scheduling, referrals, authorizations, and account follow-up. Provides support to leadership facilitating quality improvement by reporting problems, concerns, and opportunities for increased revenue and decreased denials. Assists in training and development of new staff members through the quality assurance process.
Operates standard office equipment including telephone, copier, embossers and fax machine; prepares written correspondence and completes various forms. Reviews all accounts assigned for collection prior to, during, or after admission and discharge. Obtains demographic and insurance information for preadmission.
Verifies benefits and pre-registers when appropriate. Initiates precertification when necessary. Verifies insurance as needed to resolve account balances.
Obtains necessary financial data to set up patient payment arrangements when needed. Completes Financial Statement and gets approval on arrangements exceeding three months to completion. Works with staff to ensure best estimates of services.
Performs progressive collection steps to discuss and clear balances on multiple accounts. Researches status of Medicare, Medicaid, and Blue Cross accounts through use of MEDA and BCH, accepted batch listing reports, EOB, and other information. Bills third party payors, when appropriate, by hard copy or electronic submission.
Performs special billing tasks such as combined and split bills as needed. Performs collection follow up support on assigned third party accounts. Coordinates activity with collections staff to ensure timely, accurate rebill of accounts.
Inquires about status of payments from insurance carriers. Ensures payment is received when expected; immediately pursues billing secondary insurance or billing the patient; applies appropriate allowance and adjustments. Recommends adjustments as appropriate to bring timely resolution to accounts.
Maintains up-to-date knowledge of insurance plans and current contracts, co-payments and deductibles. Interfaces successfully with insurance carriers. Maintains knowledge of current government and hospital contracts and working knowledge of co-payments and deductibles.
Maintains and is familiar with UB92 and HCFA Billing Manuals. Coordinates classification for bad debt and charity. Maintains knowledge and is familiar with Healthquest system.
Serves as a patient advocate during the cycle of the account. Communicates organization's financial policies to patients. Identifies patients who require early financial counseling intervention.
Provides information regarding resources for patients who need financial help. Works with manager/supervisor to formulate plan for professional development. Attends educational in-services as appropriate.
High school diploma or equivalent. Must have atleast four (4) years healthcare related experience. Knowledge of Medicare, Medicaid, and other contract payers (HMO, PPO) preferred.
CPAR (Certified Patient Account Representative) and/or CPFC (Certified Patient Financial Counselor) preferred for positions in hospital setting. Typing skills with a minimum of 35 wpm and good communication skills. PHYSICAL REQUIREMENTS (Medium Max 25lbs): up to 25 lbs, 0-33% of the work day (occasionally); 11-25 lbs, 34-66% of the workday (frequently); 01-10 lbs, 67-100% of the workday (constantly); Lifting 25 lbs max; Carrying of objects up to 25 lbs; Occasional to frequent standing & walking, Occasional sitting, Close eye work (computers, typing, reading, writing), Physical demands may vary depending on assigned work area and work tasks.
ENVIRONMENTAL FACTORS: Factors affecting environment conditions may vary depending on the assigned work area and tasks. Environmental exposures include, but are not limited to: Blood-borne pathogen exposure Bio-hazardous waste Chemicals/gases/fumes/vapors Communicable diseases Electrical shock, Floor Surfaces, Hot/Cold Temperatures, Indoor/Outdoor conditions, Latex, Lighting, Patient care/handling injuries, Radiation, Shift work, Travel may be required.
Use of personal protective equipment, including respirators, environmental conditions may vary depending on assigned work area and work tasks. Additional Details Emory is an equal opportunity employer, and qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or other characteristics protected by state or federal law.
Emory Healthcare is committed to providing reasonable accommodations to qualified individuals with disabilities upon request. Please contact Emory Healthcare’s Human Resources at careers@emoryhealthcare.org. Please note that one week's advance notice is preferred.
40 hours per week