Credit Applications Specialist - Self Pay
Essential Duties and Responsibilities:
The Credit Applications Specialist is responsible to research and troubleshoot for various payers. Verifying and processing refunds, post payments, and payment transfers.
- Accurately and effectively research and resolve self-pay and insurance payment credits and offsets through transfer of payments and/or initiation of refunds.
- Verify refunds are appropriately requested and complete Refund Request form.
- Ensure all appropriate documentation to process refunds is included. Obtain any missing necessary documentation.
- Perform manual posting of various commercial insurance and AHCCCS-- posting from EOBS and edits of electronic remits.
- Perform manual posting of self pay and patient responsibility payments.
- Accurately post payments and appropriately document in the system so that all staff can understand and can be used as legal doument if necessary.
- Effectively communicate with other staff members and management.
- Efficiently and effectively navigate IDX, Impower, Adobe Acrobat and payer portals.
- Maintain client and patient confidentiality.
- Manage special projects as assigned by supervisor.
- Other tasks as assigned by Director of Operations, Associate Director of Billing, or other members of Management Team
- Maintain compliance with all company policies and procedures.
- 3+ years medical collections experience preferred.
- 2+ years medical payment posting experience preferred.
- Prior experience with IDX, EPIC, Microsoft Access & Excel preferred.
- High school diploma or equivalent.
- Billing certification preferred.
- Must have a strong understanding of insurance carrier payment and insurance EOBs plus ability to follow the payment through recoupments, offsets, etc.
- Strong math skills as pertains determining correct payments and contractual adjustments.
- Knowledge working with commercial insurance, Medicare, Medicaid, AHCCCS.
- Health Insurance knowledge with regards to billling requirements, timely filing requirements and appeals process.
- General understanding of accounting debits and credits.
- Understanding/compliance of HIPAA laws and regulations.
- Computer proficiency (MS Office – Word, Excel and Outlook)
- Ability to manage multiple tasks and assignments.
- Problem solving and analytical skills.
- Excellent verbal and written communication skills.
- Ability to read, understand and follow oral and written instructions.
- Must be well organized, detail oriented and demonstrate exceptional accuracy.
- Ability to work independently and to carry out assignments to completion within parameters of instructions given, prescribed routines, and standard accepted practices.
- Able to work in a team environment.
- Ability to work with minimal supervision
- Ability to adapt to shifting priorities, seek supervision in prioritizing assigned tasks.
- Ability to operate standard office machines and equipment, including telephones, computers, copy machines, fax machines, calculators, scanners.
- Ability to safely and successfully perform the essential job functions consistent with the ADA, FMLA and other federal, state and local standards, including meeting qualitative and/or quantitative productivity standards.
- Ability to maintain regular, punctual attendance consistent with the ADA, FMLA and other federal, state and local standards
- Must be able to talk, listen, and speak clearly on telephone.
- Requires sitting and standing associated with a normal office environment.
- Manual dexterity needed for using a ten key calculator and computer keyboard.
- Specific vision abilities include close vision, distance vision, depth perception and the ability to adjust focus.
Environmental Working Conditions:
- Normal office environment.
- The noise level of the work environment is usually moderate.
- Occasional overtime maybe required and/or hours may be shortened as business needs dictate.
*The job holder must demonstrate current competencies applicable to the position.
Job Status: Full Time