PFS RECEIVABLE ANALYST in Indianapolis, IN at Eskenazi Health

Date Posted: 11/10/2019

Job Snapshot

  • Employee Type:
    Full-Time
  • Job Type:
  • Experience:
    Not Specified
  • Date Posted:
    11/10/2019

Job Description



Organization: HHC



Division:Eskenazi Health  



Sub-Division: Hospital  



Req ID:  1856 



Schedule: Full Time 



Shift: Days 

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 315-bed hospital and outpatient facilities both on and off of the Eskenazi Health downtown campus as well as at 10 Eskenazi Health Center sites located throughout Indianapolis.



JOB SUMMARY:

The PFS Receivable Analyst provides timely and accurate billing to facilitate optimized reimbursement, research and performance improvement initiatives. This includes the verification of billing data for accuracy and completeness, following regulatory requirements, and in order to resolve edits or exceptions detected during system processing of the claim in the patient accounting system, claim editing system or the payer, reviewing the medical record, facility protocol, other applicable documentation, and the understanding of payer denials, appeals process, and credit balances.



ESSENTIAL JOB FUNCTIONS:

  • 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’s values of Professionalism, Respect, Innovation, Development and Excellence
  • Responsible for the management and effective resolution of assigned high balance patient accounts to ensure appropriate cash flow is maintained, and patient satisfaction with administrative functions at Eskenazi Health are consistently positive; ensures timeframes are maintained according to Eskenazi Health policies and procedures, federal and state statutes, and payer’s claim filing timelines
  • Responsible for the resolution of credit balances that have an outstanding high balance for hospital accounts
  • Troubleshoots current problems, anticipates potential problems and communicates regularly with Revenue Cycle Management team to clarify receivable issues and to resolve immediate problems
  • Collaborates with internal departments regarding registration, prior authorizations and/or insurance issues
  • Serves as a resource to other departments to resolve problems and expedite billing and collection processes
  • Analyzes standard system reports to ensure timely and accurate data processing
  • Answers e-mails and voicemails on a timely basis
  • Responsible for identifying and trending payer rejections and denials; implements system process improvements to prevent future rejections and denials
  • Coordinates with management and system support to identify opportunities to improve system automated process based on payer guidelines and regulations
  • Keeps up to date on account billing and collection rules and regulations, contract terms and conditions with regards to timely filing and service pre-certifications and authorizations
  • Works efficiently under pressure, acts independently and accepts responsibility for decisions
  • Provides coaching and mentoring to billing and follow up team members
  • Participates in monthly staff meetings to educate new payer habits and etc. as needed
  • Acts as liaison between department and division
  • Meets with insurance company representative to ensure positive and productive relationships
  • Completes payer appeals based on under payment, timely filing, medical necessity and prior authorizations
  • Works with management when contract variances are identified



JOB REQUIREMENTS:

  • Associate degree in business-related field preferred
  • Five years of accounts receivable experience in a hospital billing environment may be accepted in lieu of formal education

Accredited by The Joint Commission and named one of the nation’s 150 best places to work by Becker’s Hospital Review for four consecutive years and Forbes list of best places to work for women, and Forbes list of America’s best midsize employers’ 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, the first community mental health center in Indiana and the Eskenazi Health Center Primary Care – Center of Excellence in Women’s Health, just to name a few.

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