Facility: Corporate Offices

City San Diego

Department

Job Status

Regular

Shift

Day

FTE

1

Shift Start Time

Shift End Time

H.S. Diploma or Equivalent

Hours :

Shift Start Time:

Variable

Shift End Time:

Variable

AWS Hours Requirement:

8/40 - 8 Hour Shift

Additional Shift Information:

7-9am - 3:30-5:30pm

Weekend Requirements:

As Needed

On-Call Required:

No

Hourly Pay Range (Minimum - Midpoint - Maximum):

$23.500 - $28.081 - $32.662

The stated pay scale reflects the range that Sharp reasonably expects to pay for this position.  The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant’s years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices.

What You Will Do

To ensure accurate posting of cash receipts and reconciliation of credit balances on patient accounts. Under the supervision of the Team Lead, the position is responsible for identifying errors, researching accounts, and proactively following up with appropriate contacts to ensure necessary information is obtained in order to resolve issues for timely posting of accounts receivables.

Required Qualifications

• 2 Years experience in a clinical or hospital Business Office.

• 2 Years experience in the Healthcare field, 10 key on a keyboard, knowledge of software programs, Microsoft office (Word & Excel).

• Experience in all EOB posting both paper EOB as well as 835-EDI.

Preferred Qualifications

• H.S. Diploma or Equivalent

Essential Functions

• Account reviewAccurately read and comprehend all insurance remittance advice.Accurately identify an invoice from an EOB to apply information for invoice resolution from an insurance company.Accurately identify patient accounts to apply patient cash to patient invoice.Accurately identify a patient credit for immediate processing.Accurately identifies appropriate ANSI rejection code to post for all zero EOB's, if not clear calls insurance company for clarification.

• Maintains files and recordkeepingAccurately update address in IDX from Mail Returns.Record accurately site last seen in IDX from Mail Returns.Maintain monthly excel file for mail returns by entity.Accurately repost dollars in IDX for bank un-honored checks.Accurately post charges for return check fees.Generate letters regarding returned check charges and fees to patients.Generate an Excel sheet for un-honored checks and fees for back up to be put in OnBase with original return check copies.Work CPP files (Credit patient pending) for escheatment.Work all ESE and ECP 49.99 below and/or above for reporting to the state.Send sue diligence letters to patients with credits greater than 49.99.Update patient account with new addresses when obtained.Void and reissue checks when received in return mail with updated information.Contact patient via phone, letter, or email to research uncashed checks from the escheatment file.Contact insurance companies for update address and to verify refunds when receive return mail.Update patient account when checks are received as a stop payment or insufficient funds from insurance companies.

• Patient account processingAccurately post daily payments to patient accounts.Accurately post daily adjustments to patient accounts.Accurately post 835 EDI edits to patient accounts.Accurately post secondary payment to patient account.Accurately determine patient responsibility.Accurately post credit card (i.e., patient or insurance) to appropriate invoice.Accurately post payment to invoice and identify credit and handle patient credits immediately.Accurately posts correct ANSI rejection code for all zero EOB's.Post all payments assigned from prior days deposit to current posting day.Accurately balances and closes batch daily.

• Payment processingAccurately access payer websites to obtain EOB's for posting.Accurately match EOB's and revenue files for posting.Accurately process refund files to AP for checks and insurance patient.Accurately determine that refund amounts that are being requested are valid for patient and insurance.Process credit cards for payment and posting to IDX.Process Merlin reports for credit card dollars to be posted.Accurately transfer revenue files with correct EOB's to OnBase.Attach correct back up information for refund checks.Contact insurance companies for research when necessary.Able to read and EOB.

Knowledge, Skills, and Abilities

• Show strong comprehension of reading an Explanation of Benefits (EOB) and knowledge of ANSI X12-5010 rejection codes.

• Have knowledge of insurance benefits, covered services, and reimbursement procedures of all HMO, PPO and Government insurance programs.

• This position has to have the ability to determine primary, secondary and third-party responsibility among insurance companies.

• The position needs to be able to determine the processing of rejection codes and how to move a claim forward.

• There is also the need to have familiarity with regulations governing collection and escheatment processes.

• It is a must for this position to have basic knowledge of word processing and spreadsheet applications and practical knowledge of CPT, ICD, HPCS, usage in the billing of physician professional claims, as well as strong knowledge of account reconciliation.

• Strong comprehension of arithmetic and 10 key by touch, be able to type a speed of 50 wpm, or in-line keying speed of 50 wpm.

• Demonstrate the ability to communicate effectively both verbal and written, ability to discuss insurance or patient account resolution with patient and/or insurance and banking representatives regarding credit and collections policies and procedures and payment issues.

• Good telephone communication skills a must.

• The employee must be able to follow directions, get along with others and handle stress.

• The employee needs to possess the ability to work well in a team environment, maintain a professional attitude, maintain confidentiality at all times.

• The employee must be able to work overtime during the week as well as on weekends to accommodate the goals of the department and month end processing, when required.

Sharp HealthCare is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability or any other protected class