Cape Cod Healthcare
Receivables Resolution Specialist
Cape Cod Healthcare, Oklahoma City, Oklahoma, United States
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Receivables Resolution Specialist
role at
Cape Cod Healthcare .
Responsibilities
Perform accurate and timely follow‑up, reconciliation, and resolution of outstanding account balances.
Analyze and resolve outstanding receivables utilizing remittance reports, payment advisories, explanation of benefits, etc.
Verify accuracy of third‑party payments.
Post contractual allowances where necessary.
Refer accounts for billing where appropriate; reassign eligible balances to self‑pay and/or third‑party billing status.
Process third‑party payor denials and related correspondence in a timely and accurate manner.
Perform administrative and clerical functions, including but not limited to typing, photo‑copying, filing, calculating, faxing, etc., as assigned.
Collaborate and interact with all departments to resolve edit errors.
Maintain job knowledge adequate to effectively carry out the responsibilities of assigned insurance(s) group, including CPT, HCPC, occurrence, condition, span and value codes in addition to modifiers.
Maintain supporting documentation for all account changes with originating department sign‑off.
Pursue other insurance information through eligibility verification and check claims status utilizing online access and individual insurance carrier websites.
Review billing, payment, and denial information utilizing a number of automated databases.
Identify potential reasons for payment denial, initiate and follow through with appropriate remedial action.
Utilize third‑party denial management system to provide reports and workflow denials.
Perform follow‑up activities on unpaid accounts through downloaded trial balances, internet insurance websites, and other reports and/or claim listings where appropriate.
Perform individual claim correction, adjustments, and cancellations through online access to specific payors websites.
Calculate patient liability and perform system adjustments to support accurate patient statement billing as needed.
Respond to patient and/or insurer inquiries in a professional, timely, efficient and knowledgeable fashion, ensuring HIPAA and CCHC guidelines are followed.
Monitor credit balance reports and perform analysis to make appropriate claims adjustments and/or refunds as necessary.
Create and maintain logs and reports as needed to support patient account activities.
Assist the department and act as a team member by covering for absences, training activities, etc., in support of hospital and departmental work activities.
Comply with departmental and organizational policies, including but not limited to dress code, use of supplies, phones and computers.
Adhere to work schedules and maintain a safe and orderly work area at all times, maintaining awareness of and compliance with safety policies and procedures.
Attend and participate in educational programs, in‑service meetings, workshops, and other activities as related to job performance, job knowledge and state regulations.
Analyze automated computer output consistently.
Provide service excellence to all patients, family members, visitors, volunteers and co‑workers.
Perform other job‑related duties and assignments as requested.
Qualifications
Ability to read, write, and communicate in English.
Ability to work independently in a high‑paced and high‑demand environment or setting.
High School diploma or GED required.
12 months experience in accounts receivable, third‑party medical billing or revenue cycle OR successful passage of the Patient Financial Services Qualifying Test.
Successful passage of basic Medical Terminology course OR successful passage of the CCHC Medical Terminology exam.
PC skills, including Microsoft Excel, Word and Outlook.
Experience in a healthcare setting preferred; prior healthcare/hospital experience with knowledge of EPIC or other hospital patient accounting system preferred.
Purpose of Position Perform accurate and timely account resolution.
Schedule Details 40 hrs per week, Mon‑Fri, 7a‑3p or 8a‑4p, No Weekends & No Holidays.
Organization Cape Cod Hospital.
Primary Location Massachusetts‑Hyannis.
Department CCH‑HB Patient Financial Services.
Annual/Hourly Hourly.
Hiring Pay Range 18.68.
Seniority Level Entry level.
Employment Type Contract.
Job Function Other.
Industries Hospitals and Health Care.
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Receivables Resolution Specialist
role at
Cape Cod Healthcare .
Responsibilities
Perform accurate and timely follow‑up, reconciliation, and resolution of outstanding account balances.
Analyze and resolve outstanding receivables utilizing remittance reports, payment advisories, explanation of benefits, etc.
Verify accuracy of third‑party payments.
Post contractual allowances where necessary.
Refer accounts for billing where appropriate; reassign eligible balances to self‑pay and/or third‑party billing status.
Process third‑party payor denials and related correspondence in a timely and accurate manner.
Perform administrative and clerical functions, including but not limited to typing, photo‑copying, filing, calculating, faxing, etc., as assigned.
Collaborate and interact with all departments to resolve edit errors.
Maintain job knowledge adequate to effectively carry out the responsibilities of assigned insurance(s) group, including CPT, HCPC, occurrence, condition, span and value codes in addition to modifiers.
Maintain supporting documentation for all account changes with originating department sign‑off.
Pursue other insurance information through eligibility verification and check claims status utilizing online access and individual insurance carrier websites.
Review billing, payment, and denial information utilizing a number of automated databases.
Identify potential reasons for payment denial, initiate and follow through with appropriate remedial action.
Utilize third‑party denial management system to provide reports and workflow denials.
Perform follow‑up activities on unpaid accounts through downloaded trial balances, internet insurance websites, and other reports and/or claim listings where appropriate.
Perform individual claim correction, adjustments, and cancellations through online access to specific payors websites.
Calculate patient liability and perform system adjustments to support accurate patient statement billing as needed.
Respond to patient and/or insurer inquiries in a professional, timely, efficient and knowledgeable fashion, ensuring HIPAA and CCHC guidelines are followed.
Monitor credit balance reports and perform analysis to make appropriate claims adjustments and/or refunds as necessary.
Create and maintain logs and reports as needed to support patient account activities.
Assist the department and act as a team member by covering for absences, training activities, etc., in support of hospital and departmental work activities.
Comply with departmental and organizational policies, including but not limited to dress code, use of supplies, phones and computers.
Adhere to work schedules and maintain a safe and orderly work area at all times, maintaining awareness of and compliance with safety policies and procedures.
Attend and participate in educational programs, in‑service meetings, workshops, and other activities as related to job performance, job knowledge and state regulations.
Analyze automated computer output consistently.
Provide service excellence to all patients, family members, visitors, volunteers and co‑workers.
Perform other job‑related duties and assignments as requested.
Qualifications
Ability to read, write, and communicate in English.
Ability to work independently in a high‑paced and high‑demand environment or setting.
High School diploma or GED required.
12 months experience in accounts receivable, third‑party medical billing or revenue cycle OR successful passage of the Patient Financial Services Qualifying Test.
Successful passage of basic Medical Terminology course OR successful passage of the CCHC Medical Terminology exam.
PC skills, including Microsoft Excel, Word and Outlook.
Experience in a healthcare setting preferred; prior healthcare/hospital experience with knowledge of EPIC or other hospital patient accounting system preferred.
Purpose of Position Perform accurate and timely account resolution.
Schedule Details 40 hrs per week, Mon‑Fri, 7a‑3p or 8a‑4p, No Weekends & No Holidays.
Organization Cape Cod Hospital.
Primary Location Massachusetts‑Hyannis.
Department CCH‑HB Patient Financial Services.
Annual/Hourly Hourly.
Hiring Pay Range 18.68.
Seniority Level Entry level.
Employment Type Contract.
Job Function Other.
Industries Hospitals and Health Care.
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