Eskenazi Health serves as the public hospital division of the Health & Hospital Corporation of Marion County. Physicians provide a comprehensive range of primary and specialty care services at the 333-bed hospital and outpatient facilities both on and off of the Eskenazi Health downtown campus including at a network of Eskenazi Health Center sites located throughout Indianapolis.
FLSA Status
Non-Exempt
Job Role Summary
The Accounts Receivable Specialist may be responsible for maintaining the life of a claim which may include the following:Initiate Billing, Charge Entry, Claim Edit, DNB, Stop Bills, Claim Rejection, Denial, Follow-up, No Response, Variance, Correspondence and Credit Balance Resolution. The Accounts Receivable Specialist communicates with the insurance carriers to ensure appropriate and compliant payment of services via: telephone, email, fax, payor website. This position reviews reports to determine trends and discusses with management to help resolve front-end errors, reviews and follows up on all claims not paid by carriers in a timely manner and claims not paid appropriately.
Essential Functions and Responsibilities
Proactively contributes to Eskenazi Health's mission: Advocate, Care, Teach and Serve with special emphasis on the vulnerable population of Marion County. Models Eskenazi Health values of Professionalism, Respect, Innovation, Development and Excellence.
Assist customer service with follows up on patient calls within a timely manner
Maintains department weekly production and monthly quality measures
Communicates effectively and appropriately with internal and external customers
Acts independently seeking guidance when necessary to remain compliant with federal, state, and hospital policies relative to insurance patient billing
Initiates proper course of action for problem solving resolution
Analyzes all claim denials to determine the best course of action to resolve any issue and receive appropriate payment
Verifies and updates claims with insurance and demographic information when changes are needed
Resolves inquiries from internal and external customers
Takes active role in special projects as requested
Gathers and distributes insurance information obtained through verbal and/or written communication for the purpose of maintaining sufficient cash flow
Analyzes and resolves issues reported from the self-pay outsource vendor
Utilizes interpersonal communication strategies/skills to achieve desired outcome/results with patients/families and others
Provides coverage for co-workers as necessary due to PTO/illness
Continues knowledge based learning on payor guidelines and requirements for appropriate billing
Enter daily charges for NTP clinic
Works charge review in a timely and accurate manner to ensure appropriate billing of services
Associate Degree in business-related field or technical training in coding and/or billing in lieu of
Three years of experience in medical practice/hospital setting with billing, insurance follow-up and/or credit balance experience.
CPC Certification a plus
Dental, Vision, Behavioral Health and/or DME experience a plus
Knowledge, Skills & Abilities
Pays close attention to detail with accuracy in record keeping and documentation Identifies trends with denials (providers/locations/carriers) and works with management to help educate or resolve errors from the start and avoid back-end denials Willingness and ability to assist other team members Excellent problem-solving skills and ability to cooperate with others Works independently and efficiently Working knowledge of Microsoft Office Software, Windows Utilizes calculator, printers, copiers, and fax machines Strong math skills Strong organizational skills and ability to work efficiently in a high volume, multi-task environment meeting deadlines Uses professional and appropriate communication skills Advanced understanding of health insurance medical policy and billing requirements, including government and managed care programs as well as traditional Medicaid, Medicare replacement plans, commercial carriers, HIP, Anthem Ability to meet production and accuracy requirements outlined by department goals
Accredited by The Joint Commission and named as one of Indiana's best employers by Forbes magazine for two consecutive years and the top hospital in the state for community benefit by the Lown Institute, Eskenazi Health's programs have received national recognition while also offering new health care opportunities to the local community. As the sponsoring hospital for Indianapolis Emergency Medical Services, the city's primary EMS provider, Eskenazi Health is also home to the first adult Level I trauma center in Indiana, the only verified adult burn center in Indiana and Sandra Eskenazi Mental Health Center, the first community mental health center in Indiana, just to name a few.
