Openings >> Trauma Reimbursement Analyst Full Time
Trauma Reimbursement Analyst Full Time
Summary
Title:Trauma Reimbursement Analyst Full Time
ID:1868
Department:PRD
Location:Main Clinic--Columbus, GA
Description
 The Hughston Clinic, The Hughston Foundation, The Hughston Surgical Center, Hughston Clinic Orthopaedics, and Jack Hughston Memorial Hospital participate in E-Verify. This company is an equal opportunity employer that recruits and hires qualified candidates without regard to race, religion, color, sex, sexual orientation, gender identity, age, national origin, ancestry, citizenship, disability, or protected veteran status. This company is a VEVRAA Federal Contractor.
 
Position Goal: Maintains overall understanding of assigned payor to include CMS regulations and billing requirements.   Serves as a liaison between clinic and assigned payor.

Position Responsibilites;
  • Organizes clinic claims for electronic or hard copy mail and ensures expected receipt by appropriate third party payors.
  • Reviews claims to ensure payor specific billing requirements are met, follows up on billing, determines and applies appropriate adjustments, answers questions and updates accounts as necessary.
  • Manage assigned Payor hold/Manager hold buckets.
  • Contact payor in a timely manner as dictated by payor to ensure expected revenue without delay
  • Manage zero pay work list
  • Ensures timely filing/follow up requirements followed by payor
  • Assist patients with questions/payments on their accounts.
  • Appropriately appeal insurance claims in a timely manner.
  • Research and write up refunds in a timely manner.
  • Minimize Days in Accounts Receivable. 
  • Establish /maintain relationships with Trauma Clinical Staff.
  • Vast knowledge of Meditech and Citrix patient management systems.
  • Vast understanding or State Law Medical Billing Requirements.
  • Communicate and management of Out of State billing policies.
  • Performs other duties as assigned by Management

Experience: Three years medical collection experience required.  Knowledge of CPT and ICD-10 terminology. Coding certification preferred.  Familiar with standard concepts, practices and procedures of this particular field.
Education: High school diploma or equivalent required
Special Qualifications: Must be able to work independently. Strong attention to detail required. 

 

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