EDUCATION, EXPERIENCE AND CERTIFICATIONS

High school diploma or GED required. Two-years’ experience in related financial services or healthcare business office required. College (bachelor’s or associate) degree preferred. Requires the ability to communicate effectively in verbal and written formats. Proficiency in Word, Excel and Outlook preferred. Prior healthcare computer system and specifically Epic billing experience preferred.

• Prepares reports of denials, credit balances, payer opportunities.
• Analyzes rejection reports and errors made by system and teammates. Requests system changes, reports error rates by teammate and collaborates with training to ensure improvement is achieved and sustained.
• Prepares Medicare/Medicaid quarterly credit balance reports. Approve refunds as defined in departmental threshold guidelines.
• Assists Supervisor/ Manager with quality checks for all payers and departments.
• Performs quality assurance tasks as needed to validate workflow builds, claim edit actions, automatic actions in Epic, process improvements, etc.
• Analyzes denial reasons provided by payers. Collaborates with management to identify, trend and address root causes of denials.
• Researches and analyzes payer trends and works on special projects involving aged, high dollar or complex account issues.
• Trains new teammates as needed