Responsible for preparing and submitting third party claims for reimbursement, posting third party cash receipts, accounts receivable follow-up, collection activities, and additional duties in support of programs.
Performs data entry into automated occupational medicine software system.
Prepares monthly invoices detailing services performed for third parties, posting of cash receipts, and preparation of other reports and statements as necessary.
Prepares, reviews, and submits certain claims for reimbursement.
Obtains required forms and prepares correspondence for each third party file.
Investigates discrepancies between authorizations issued and claims submitted, and submits claim forms with appropriate corresponding documentation to third parties.
Requests and documents third party pre-authorizations.
Provides patient financial counseling prior to the test, as appropriate.
Reviews and investigates rejected or denied claims.
Researches, corrects, and resubmits claims for payment.
Identifies delinquent accounts.
Performs follow-up with third parties and employers regarding payment by placing telephone calls, preparing correspondence, or resubmitting claims when necessary.
Maintains confidentiality of patient information.
Assists in the creation, generation, and distribution of informative reports to meet financial reporting needs.
Alerts of unusual developments of critical situations concerning billing, accounts receivable, or collection issues.
Work is typically performed in an office environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job. *Relevant experience may be a combination of related work experience and degree obtained (Associate's Degree = 2 years; Bachelor's Degree = 4 years).
High School Diploma or Equivalent (GED)- (Required)
Minimum of 4 years-Relevant experience* (Required)
Certification(s) and License(s)
OUR PURPOSE & VALUES: Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities. KINDNESS: We strive to treat everyone as we would hope to be treated ourselves. EXCELLENCE: We treasure colleagues who humbly strive for excellence. LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow. INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation. SAFETY: We provide a safe environment for our patients and members and the Geisinger family We offer healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners.* Perhaps just as important, from senior management on down, we encourage an atmosphere of collaboration, cooperation and collegiality. We are an Affirmative Action, Equal Opportunity Employer Women and Minorities are Encouraged to Apply. All qualified applicants will receive consideration for employment and will not be discriminated against on the basis of disability or their protected veteran status.
We are an Affirmative Action, Equal Opportunity Employer Women and Minorities are Encouraged to Apply. All qualified applicants will receive consideration for employment and will not be discriminated against on the basis of disability or their protected veteran status.
At Geisinger, our innovative ideas are inspired by the communities we serve – like our Fresh FoodFarmacy, a program that delivers life-saving healthy alternatives to patients with diabetes. With additional tools like our MyCode Community Health Initiative, one of the first health system genome sequencingprograms, and our new asthma app suite that we developed in partnership with AstraZeneca, it’s no wonder we’re ranked one of the Top 5 Most Innovative Healthcare Systems by Becker's Hospital Review. We continually work towards continuous improvement in a culture where everyone has a voice and firmly believe that better begins with all of us.Founded more than 100 years ago, Geisinger serves more than three million residents throughout central, south-central and northeastern Pennsylvania and southern New Jersey. Our physician-led system is comprised of 30,000 employees, including 1,600 employed physicians, and consists of 13... hospital campuses, the Geisinger Health Plan, Geisinger Commonwealth School of Medicine and two research centers. What you do at Geisinger shapes the future of health and improves lives – for our patients, communities, and you.