Sunday , February 5 2023

Sutter Health Employment For Team Member, Claims

Website Sutter Health

Job Description:

Supports the delivery of all billing services by final/higher level auditing, correcting, and submitting 3rd party claims and patient statements. Ensures that billing services are timely, accurate, and appropriate reimbursement. Conducts all claims related follow up on payment delays, taking corrective action(s) to finalize account disposition and/or referring claims to the appropriate staff so as to ensure appropriate reimbursement in the most timely manner possible.

Job Requirements:

  • Ability to execute strategy and communicate knowledge of business processes and enabling technologies, specifically in a Payer-specific (Medicare, MediCal, Medicaid, and/or Private) Claims function
  • Aptitude to conceptualize, plan, and implement stated goals and objectives
  • Knowledge of principles, methods, and techniques related to compliant healthcare billing/collections
  • In-depth knowledge of Revenue Cycle applications, including Hospital Patient Accounting
  • Familiarity with Payer-specific (Medicare, MediCal, Medicaid, Private) Claims management functions in acute and non-acute settings
  • Requires strong accuracy, attentiveness to detail and time management skills
    commercial third party payers, and/or managed care contracts and coordination of benefits
  • In-depth knowledge/ awareness of all areas related to Payer-specific (Medicare, MediCal, Medicaid, and/or Private) Claims and how they interrelate
  • Familiarity with medical terminology and the medical record coding process
  • Ability to comprehend and retain information that can be applied to work procedures to achieve appropriate service delivery
  • Ability to independently set and organize own work priorities for self, and successfully adapt to new priorities as part of a changing environment.
  • Must be able to work concurrently on a variety of tasks/projects in an environment that demands a high degree of accuracy and productivity in cooperation with individuals having diverse personalities and work styles
  • Knowledge of Patient Management information system applications, preferably EPIC
  • Data entry skills (minimum 50-60 accurate keystrokes per minute)

Qualification & Experience:

  • Demonstrates experience and a proven track record in Payer-specific (Medicare, MediCal, Medicaid, and/or Private) Claims in a facility of significant size and complexity, hospital business operations, information systems, and patient accounting applications, as typically acquired in 0-2 years of acute hospital patient accounting positions required
  • Experience participating in Payer-specific (Medicare, MediCal, Medicaid, and/or Private) Claims standards, processes, policies, procedures and service level agreements is required
  • Associate’s Degree in Accounting or Business or the equivalent education/experience required

Job Details:

Company: Sutter Health

Vacancy Type: Full Time

Job Functions: Other

Job Location: Salt Lake City, UT, US

Application Deadline: N/A

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