Central Billing Office Professional
Company: West Penn Allegheny Health System
Location: Harrisburg
Posted on: January 17, 2023
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Job Description:
Company :Allegheny Health NetworkJob Description :GENERAL
OVERVIEW:This job is responsible for providing support, covering
all aspects of insurance billing, claims follow up and collections,
including direct contact to the appropriate third-party payers for
all unpaid claims including denied claims and those requiring
appeal.ESSENTIAL RESPONSIBILITIES:Ensures efficient processing of
billing claims, insurance follow up, collection activities and
denials. Assists in meeting cash collection goals by reviewing,
completing, and submitting appropriate documentation based on payer
requirements. Conducts research and provides updates and current
status of collection efforts using the appropriate data management
system (EPIC/Meditech).Performs billing, follow-up and collection
functions for third parties, resolving issues that impact or delay
claims payment. Communicates information and ideas to make
system-wide process improvements. Updates data regarding changes
and modifications in plan benefits and other contract information
relevant to the billing or claims follow up and collection
process.Serves as support staff for various departments and
external payers by developing positive relationships with managed
care organizations and outside agencies, and clinical areas within
the organization. Reviews and responds to correspondence and
inquiries generated by third party payers. Provides medical record
copies and other pertinent information to the appropriate sources
throughout the billing and collection process. Works
collaboratively to facilitate the insurance billing and collections
process to improve overall cash collection.Supports overall Revenue
Cycle processes to achieve established targets and goals, including
the completion of special/specific assigned projects or
tasks.Monitors the status of denials, appeals, and claim errors by
using folders/work queues and conducting routine, periodic follow
up on previously researched claims items. Monitors, reviews, and
suggests revisions or updates to existing forms, documents, and
processes required to facilitate timely billing and
collections.Ensures completeness of claims by following national,
local, and internal billing requirements promoting prompt and
accurate submission and payment. Maintains awareness of current
regulations. Initiates practices that support current
regulations.Performs other duties as assigned or
requiredQUALIFICATIONS:MinimumHealth care experience of up to 3
yearsPreferredAssociate's Degree/completion of college level
courseworkDisclaimer: The job description has been designed to
indicate the general nature and essential duties and
responsibilities of work performed by employees within this job
title. It may not contain a comprehensive inventory of all duties,
responsibilities, and qualifications required of employees to do
this pliance Requirement: This job adheres to the ethical and legal
standards and behavioral expectations as set forth in the code of
business conduct and company policies.As a component of job
responsibilities, employees may have access to covered information,
cardholder data, or other confidential customer information that
must be protected at all times. In connection with this, all
employees must comply with both the Health Insurance Portability
Accountability Act of 1996 (HIPAA) as described in the Notice of
Privacy Practices and Privacy Policies and Procedures as well as
all data security guidelines established within the Company's
Handbook of Privacy Policies and Practices and Information Security
Policy.Furthermore, it is every employee's responsibility to comply
with the company's Code of Business Conduct. This includes but is
not limited to adherence to applicable federal and state laws,
rules, and regulations as well as company policies and training
requirements. Highmark Health and its affiliates prohibit
discrimination against qualified individuals based on their status
as protected veterans or individuals with disabilities, and
prohibit discrimination against all individuals based on their
race, color, religion, sex, national origin, sexual
orientation/gender identity or any other category protected by
applicable federal, state or local law. Highmark Health and its
affiliates take affirmative action to employ and advance in
employment individuals without regard to race, color, religion,
sex, national origin, sexual orientation/gender identity, protected
veteran status or disability.Highmark Health and its affiliates
prohibit discrimination against qualified individuals based on
their status as protected veterans or individuals with
disabilities, and prohibit discrimination against all individuals
based on their race, color, age, religion, sex, national origin,
sexual orientation/gender identity or any other category protected
by applicable federal, state or local law. Highmark Health and its
affiliates take affirmative action to employ and advance in
employment individuals without regard to race, color, age,
religion, sex, national origin, sexual orientation/gender identity,
protected veteran status or disability.EEO is The LawEqual
Opportunity Employer Minorities/Women/Protected
Veterans/Disabled/Sexual Orientation/Gender Identity (endeavor to
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number below.For accommodation requests, please contact HR Services
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Keywords: West Penn Allegheny Health System, Harrisburg , Central Billing Office Professional, Other , Harrisburg, Pennsylvania
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