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Accounting Clerk- Medicare/Medicaid Claims Follow-Up 150 East 42Nd Street
Company | Mount Sinai Health System |
Address | United States |
Employment type | FULL_TIME |
Salary | |
Category | Hospitals and Health Care |
Expires | 2023-08-11 |
Posted at | 10 months ago |
Description
- Collects form of payment(s) (deposits), for elective, maternity, international, deductible/co-insurance/co-pay and any other patient responsibility. This collection can be prior admission, during admission and/or after admission(bilingual preferred)
- Reconcile vender accounts. Work payment remittance and closed report/files received by outside venders.
- Posts all manual charges into the patient accounts system. Inputs appropriate data elements into PFS Systems for specific charge codes (value codes, condition codes, etc).
- Account resolution performed on accounts with credit and debit balances.
- Interviews potential Medicaid patients before admission, during admission and after discharge of admission to obtain essential documentation to process Medicaid application, financial assistance and/or determine the method of hospital reimbursement. Utilize and input into Medicaid Tracking System (MEMS) when preparation of Medicaid application is determined (bilingual preferred).
- Follow-up all billed third party/self-pay accounts. These accounts are followed up based on parameters set within area of assignment and can be different based on payer. Follow-up action(s) examples can be rebill of account, transfer, assignment of different and/or correction of insurance data, account resolution, phone call, and inquiry through third part website or call to patient. These are just examples and are not limited to these suggestions.
- Perform the preparation of patient and third party refunds.
- Obtains and validates patient’s third party health insurance. Coordinates and prioritizes insurance within PFS Systems when more than one (1) valid insurance exists. Validation of third party insurance is obtained via various eligibility systems, calls to third party carriers and/or patients ((bilingual preferred)
- Corrects denials and re-bills accounts through PFS Systems.
- Responds to patient calls or written correspondence regarding billing issues. Proper customer service techniques should be used.
- Scan documents of assignment.
- Performs other related duties as required.
- Prepares schedules on work findings, cash postings, global arrangements (splits) and all other schedule that is assigned.
- Requests Medical Records and communicates correspondence with inter-office departments.
- Post payments (manual and electronic kick-outs). Post adjustments and reconcile/disposition accounts when necessary.
- Correspondence is noted on individual patient accounts. Correspondence is worked within PFS Systems based on the parameters set with in the department all other is distributed to appropriate work area.
- Reconcile payments on accounts to ensure that payments agree with negotiated rates. Reviews listings of accounts to ensure payments are received when there are rate changes and/or annual rate increase within said contracts.
- Bills and follow-up on specific specialized accounts receivable (bilingual preferred).
- Prepares all downloads of billing files from Mainframe System to Clearing House. Transmits all clean claims daily to Clearing House and other direct payers.
- Sends bills to patients for self-pay balances (bilingual preferred).
- Respond to third party audits.
- Attends Workshops, weekly unit meets and any other meeting assigned.
- Adheres to the Stratified Process Work Environment utilizing either the On-Trac or Trac system applications.
- Edits unbilled/unprocessed accounts (billing) using PFS HIS Systems, Clearing House Claim Scrubber and/or any payer websites available for claim correction of billed accounts.
- Ensures timely completion of required work assignments.
- Distributes and sorts departmental mail received.
- Bill claims to third party payers either electronically or manually.
- Analyzes accounts to resolve issues that result in billing and/or payment delays.
- Knowledge of Microsoft Excel and Word (35 WPM min).
- Education: High School Diploma/GED
- The ability to work independently and on a team
- Experience: Excellent communication skills (oral and written)
- Knowledgeable with the Patient Accounts System(s): Eagle, MEMS, Trac/On-Trac, Cirius, FSS, Cerner, Various Insurance Websites preferred.
- Inspiring and fostering an environment of anti-racist behaviors among and between departments and co-workers.
- Using a lens of equity in all aspects of patient care delivery, education, and research to promote policies and practices to allow opportunities for all to thrive and reach their potential.
- Serving as a role model confronting racist, sexist, or other inappropriate actions by speaking up, challenging exclusionary organizational practices, and standing side-by-side in support of colleagues who experience discrimination.
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