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Job Description
Job Summary
Processes inpatient and outpatient claims to insurance companies, employers and patients. Follows claims through the payment cycle to insure timely and accurate payment by third party payers. Maintains an in-depth knowledge of payer regulations and reimbursement methodologies to assure accurate reimbursement.
Essential Functions
Processes patient and insurance payments to maintain timely cash flow and accurate account balances. Meets audit expectations, as determined by department.
Analyzes assigned accounts receivable portfolio and take appropriate action to ensure compliant, timely claim resolution.
Ensures payer and governmental agency regulatory and compliance requirements are consistently followed and applied.
Identify, verify, communicate and monitor applicable AR trends and issues. Identify and trouble shoot issues that impact claim processing delays.
Demonstrates professional communication, including verbal and written.
Adheres to department and role-specific policies, procedures and key-metrics.
Qualifications
High School Diploma or equivalent -Required
Associate's Degree related field -Preferred
2 years of relevant experience related field- Required
HDMS experience - Preferred
Epic experience - Preferred
Billing experience - Preferred
Primary Location
SITE - Business Service Center - 4420 44th St - Grand Rapids
Department Name
PFS Durable Medical Equipment
Employment Type
Full time
Shift
Day (United States of America)
Weekly Scheduled Hours
40
Hours of Work
8 a.m. to 5 p.m.
Days Worked
Monday to Friday
Weekend Frequency
N/A
Spectrum Health requires all team members to receive the COVID-19 vaccinations subject to certain exclusions based on the team member's job category. Spectrum Health is committed to granting reasonable accommodations in accordance with applicable laws.
Accommodation Notice: If you are a qualified individual with a disability, you may request a reasonable accommodation in Spectrum Health's application process. Contact us at 616-486-SHHR (7447).
Spectrum Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, sexual orientation, veteran status, or any other legally protected
category. See more here (https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf) .
Spectrum Health requires all team members to receive the COVID-19 vaccinations subject to certain exclusions based on the team member's job category. Spectrum Health is committed to granting reasonable accommodations in accordance with applicable laws.
Who We Are
Spectrum Health is a nationally recognized not-for-profit health system, offering a full continuum of health services through our health plan, medical group and hospital group. As an integrated health system, we are able to work together across all facilities, employees and providers to create exceptional, consumer-focused interactions.
Spectrum Health is redefining what it takes to improve the health of our communities and introducing new and innovative ways for consumers to access high-quality, low-cost care so that they can connect with us for a lifetime of health.
We strive to provide one Spectrum Health experience: a consistent, high-quality, seamless health journey for consumers; no matter where, when or how they interact with us. The result is better health outcomes for the thousands of individuals, families and communities we serve.
We are the region's largest employer, with corporate offices located in Grand Rapids, Michigan. Spectrum Health Hospital Group and Spectrum Health Medical Group are consistently recognized for the exceptional care they provide. Priority Health is among the largest health system-sponsored health plans in the U.S. and offers extensive experience serving large and small employer groups, individuals, Medicare Advantage, Healthy Michigan Plan and Medicaid populations.
Since 2010, Spectrum Health has been listed five times among the 15 Top Health Systems in the U.S. by Truven Analytics™. Click here (https://www.spectrumhealth.org/about-us/quality-safety-and-patient-experience/awards) to see a complete list of our safety, quality and patient experience awards.