Full-time - 40 Hours/Week
Boulder Community Health was recently honored as Best Local Employer by the Daily Camera in the 2018 Boulder County Gold, their People's Choice Awards for businesses in Boulder County. Come join us and be a part of an independent, community-focused health system and feel good knowing that your work will make a difference in people's lives and be a positive contribution to the community.
- Responsible for the review and analysis of assigned insurance/3rd party payer accounts receivable across all Physician Clinic patient accounts.
- Responsible for denials management, including analysis of insurance/3rd party payer denials, facilitation of account and billing corrections as needed, and formulation and submission of appeals to insurance/3rd party payers.
Education or Formal Training
- Minimum high school diploma or equivalent preferred
- Associates degree preferred.
Special Qualifications (Licensure, Registration, etc.)
Knowledge, Skill and Ability
- Knowledge of medical billing/collection practices.
- Knowledge of basic medical coding.
- Knowledge of medical insurance operating procedures and practices.
- Knowledge of governmental and legal regulator provisions related to medical billing and collections.
- Ability to accurately read, interpret and comprehend insurance payment Remittance Advice/Explanation of Benefits documents.
- Ability to accurately read, interpret, and comprehend data on system generated reports.
- Ability to deal professionally and courteously with insurance company representatives, patients, and co-workers.
- Good problem solving and critical thinking skills required
- High degree of interpersonal communication skills, both verbal and written.
- Basic math and accounting aptitude.
- Skill with using/learning computer applications.
- Vision necessary to accurately process paperwork and to work for extended periods of time looking at a computer monitor.
Minimum one year of insurance accounts receivable and collecting experience in medical setting
MATERIAL AND EQUIPMENT DIRECTLY USED
- General office equipment (phone, fax, printer, scanner, copier, etc.)
- Computer keyboard, PC, calculator
- Applicable computer software and web-based applications.
WORKING ENVIRONMENT/PHYSICAL ACTIVITIES
- Office environment with multiple interruptions by phone, email or in person
- Position requires long periods of sitting, data/input/typing, phone and computer usage
- Physically able to work hours defined by the position
- Occasional evening or weekend work if needed
- Hearing and visual acuity sufficient for individual and group situations (with correction aides as needed)
- Minimal lifting/bending/stretching
- Manual dexterity required for use of calculator and computer keyboard.
- On a daily basis, reviews and analyzes outstanding insurance/3rd party payer accounts receivable for accounts or payers assigned by the Accounts Receivable Supervisor or Clinic Billing Manager. Runs and/or reviews billing system generated reports and payer correspondence.
- Identifies delinquent accounts, identifies reason for delinquency, and resolves/facilitates resolution of any problems with the account to allow for payment and/or closure of outstanding/unpaid accounts.
- Identifies trends and errors in insurance/3rd party payments, resolves/facilitates resolution of errors/trends that are identified, and alerts A/R Supervisor of errors/trends.
- Responsible for follow-up and research on all insurance/3rd party payer denials. Responsible for resolving/facilitating the resolution of the reason for the denial. Responsible for appealing payment denial via individual payers required appeal process, when appropriate.
- Responsible for working with Provider Representatives from insurance/3rd party payers to resolve large-scale or stubborn claims processing errors that resulted in incorrect payment of our accounts.
About Boulder Community Health and Boulder, Colorado
Uncompromising medical excellence, delivered with the values of respect and compassion. Since 1922, Boulder Community Health has built our reputation on this promise. As a community-owned and operated not-for-profit hospital and clinics, we remain dedicated to meeting the evolving healthcare needs of our citizens and providing access to high quality medical care. Our state-of-the art facilities are home to many medical professionals who offer an extensive range of medical services.
Nestled in the foothills of the Rocky Mountains, adventure awaits you right outside your door. Big, beautiful vistas, serene snow-capped mountains, and a lifestyle conducive to enjoying the outdoors bring a truly fresh perspective to our practice of healthcare.
Surround yourself by natural beauty and an active, life-embracing community, while you enjoy state of the art facilities and equipment along with a competitive compensation and benefits package, including health/dental/life, paid annual leave, tuition reimbursement and much more.
EOE/Affirmative Action/Drug-free workplace
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