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Non-Clinical
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22002947 Requisition #

 Grady Health System offers many career paths for your professional growth. Whether you have many years of experience or are in the early stages on your career, you can find a rewarding position at Grady!

JOB SUMMARY:

The Accounts Receivables (A/R) Representative assists in review and resolution of hospital claims under general supervision of the Patient Financial Services Supervisor.

Posting, processing and balancing activities related to third party remittances on both hospital and physician-based claims and all forms of payments received from patients. The Payment Applications Representative reports to the Supervisor of Payment Applications.

Responsibilities may include one of the following:

Post, process, and balance all third party payments appropriately in patient accounting system.

Research and resolve all undistributed payments on patient accounts.

Make posting corrections.

Responsible for researching and correcting all transactions on Clearing/Undistributed accounts and WQ.

Reconcile bank deposits with remittance and payment files.

Maintain knowledge of insurance payments and rejection/denial processing.

Ensure complete, accurate, and timely account notation and documentation in the Revenue Cycle systems, including adjudication, denial processing, and imaging.

Daily focus on attaining productivity standards, recommending new approaches for enhancing performance and productivity when appropriate.

Strive for positive patient experience observing the Grady value “Patient First”

Adhere to Grady organizational policies and procedures.

Complete and/or attend mandatory training and education sessions within approved organizational guidelines and timeframes.

Other duties as assigned.

      Demonstrate critical thinking as it applies to payments and remittances received

      Process remote deposit and scanning of supporting documentation for applicable to    payments and adjustments

Posts payments and adjustments as appropriate to patient accounts based on explanation of benefits and contractual guidelines

Pays close attention to detail, ensuring accuracy of payments and adjustments

Balances all transactions posted to billing system daily and monthly, utilizing Microsoft Excel and other software

Requests and follows through on EFT/ERA loaded in the payment remittance run

Contacts insurance companies to obtain missing EOB’s and information needed to post payments and or adjustments

·Researches and corrects/applies all transactions related to unapplied payments in HB Clearing and Undistributed accounts

·Notifies Manager/Supervisor of any irregularities noticed in payments, adjustments or other nuances impacting payment posting.

MINIMUM EDUCATION REQUIRED:

High School graduate or GED.

Prior related healthcare Revenue Cycle experience, preferably within payment applications.

At least one (1) years of previous related healthcare Revenue Cycle experience, preferably with a focus in payment applications. Prior Epic experience preferred.

Two (2) or more year’s job related experience in health care revenue cycle.

 

Preferred:

1.    Hands on knowledge of Medicare and Medicaid billing regulations; Experience with (Uniform Billing) UB-04 and Health Care Finance Administration (HCFA) 1500 claim forms billing and follow up functions - both electronically and manual.

 

2.    Hands on knowledge of Current Procedural Terminology (CPT), International Classification of Diseases (ICD-9) coding, Healthcare Common Procedure Coding System (HCPCS), revenue codes and hospital billing terminology. Knowledge of Outpatient Code Editor (OCE) and Correct Coding Initiative (CCI) edits.

 

3.    Working knowledge of Medicare Secondary payer as well as medical necessity requirements.

 

4.    Demonstrated service and success in teamwork and consistent high productivity and quality.

 

5.    EPIC experience.

·Clear understanding of the impact Payment Applications has on Revenue Cycle operations and financial performance.

· Excellent written, verbal communication and interpersonal skills.

· Ability to prioritize and manage multiple tasks simultaneously, and to effectively anticipate and respond to issues as needed in a dynamic work environment.

· Dedication to treating both internal and external clients and customers, maintaining a flexible customer service approach and orientation that emphasizes service satisfaction and quality.

· A demonstrated ability to use PC based office productivity tools (e.g. Microsoft Outlook, Microsoft Excel) as necessary; general computer skills necessary to work effectively in an office environment.

Equal Opportunity Employer-Minorities/Females/Veterans/Individuals with Disabilities/Sexual Orientation/Gender Identity.

 

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