Collections & Denials Management Representative

HOW WE CARE FOR YOU

At St. Lawrence Health, we are dedicated to getting health care right. Our robust benefits and total rewards foster employee wellbeing, professional development and personal growth. We care for your career while caring for the community.

Medical, dental, vision, hearing benefits

Paid vacation & holiday pay

Same Day pay through Daily Pay

SUMMARY

The C & D specialist is responsible for reviewing accounts which have been denied or underpaid by third party payers and to resolve the issues resulting in denial/underpayment and to formally appeal. The specialist will conduct comprehensive reviews of clinical documentation to determine if an appeal is warranted. Should an appeal be necessary, the specialist will write compelling and factual arguments which will then be sent to the insurance carrier. The specialist will work across departments to gather the appropriate documentation and information for a clear and concise appeal. Responsibilities will include basic knowledge of medical billing, medical claims processing and accounts receivable collections. The Medical collection specialist must have the Ability to learn and understand medical billing protocol and reimbursement issues, work within Meditech and Emdeon to identify denial trends as well as be responsible for locating and monitoring overdue third party accounts preventing write off. Must be comfortable working tight deadlines, have the ability to analyze and trouble shoot billing concerns and communicate concerns with management.

Canton-Potsdam Hospital is a warm and caring not-for-profit community healthcare facility that's certified for 94 beds. Our mission is to provide exceptional healthcare services to the community. Within our welcoming walls, you'll find a wide array of core programs in emergency medicine, acute care, hospitalist medicine, and critical care. But that's just the beginning. We're not just a hospital; we're a beacon of health and wellness in the North Country. We proudly offer outpatient health services in Brasher Falls, Canton, Colton, Gouverneur, Massena, Norfolk, and Potsdam, NY.

STATUS: Full-time

LOCATION: SeaComm

DEPARTMENT: Patient Accounting

SCHEDULE: 7.5-hour day shift

ATTRIBUTES

Required: High school diploma

Required: 1-2 years in accounts receivable experience OR 1 year in a healthcare setting.

Preferred: Bachelor's degree in related field

Preferred: AHIMA Certified & Medical Billing Certification – AAPC Certified Professional Biller (CPB)

Preferred: 3 years of Medical office or denial management experience

RESPONSIBILITIES

Creating and navigating Meditech work lists

Compiling appeal letters to send to insurance providers

Performing consistent follow-up on pending appeals and responding to payors regarding billing issues and insurance problems

Performing Customer Service related actions

Abiding by productivity standards set by business office leadership

Reading and understanding patient medical records and ensuring HIPAA confidentiality

UNION:1199-200B Clerical Workers (CPH)

Note: Not all per diem roles are union eligible

EDUCATION:

LICENSES / CERTIFICATIONS:

PHYSICAL REQUIREMENTS:S - Sedentary Work - Exerting up to 10 pounds of force occasionally Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.

For disease specific care programs refer to the program specific requirements of the department for further specifications on experience and educational expectations, including continuing education requirements.

Any physical requirements reported by a prospective employee and/or employee’s physician or delegate will be considered for accommodations.

PAY RANGE:$18.90 - $27.43

The listed base pay range is a good faith representation of current potential base pay for a successful full time applicant. It may be modified in the future and eligible for additional pay components. Pay is determined by factors including experience, relevant qualifications, specialty, internal equity, location, and contracts.

Rochester Regional Health is an Equal Opportunity/Affirmative Action Employer.

Minority/Female/Disability/Veterans by a prospective employee and/or employee’s Physician or delegate will be considered for accommodations.

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