Business Office Manager jobs in South Bend, IN

Position Description:

• Retrieves insurance electronic 835 files from payer portals, 3^rd party resources or clearinghouse and uploads for posting preferably the same day but no later than within 24 hours of the Electronic Funds Transfer (EFT) or check being received. Posts those that kick out on the error exceptions accordingly. Ensures the posting balances tying back to the payment(s) received.
• Processes all insurance paper checks/credit card transactions and remittances posting to the appropriate computer system preferably the same day as received but no later than within 24 hours. Ensures posting is accurate and balances tying back to the payment source. Manually calculates, as needed, incomplete insurance remittances missing information such as contractuals.
• Post accurately the contractuals, to minimize account balance corrections, that are related to insurance payments appropriately recording any denial reason codes or deductible/copay/coinsurance information and if required, thorough notes in the system also preferably the same day or no later than within 24 hours of receipt of the data. Is equally thorough and accurate in the selection of the correct insurance plan to post back to and when not present, contacts the correct party to have that established. Retrieves zero payments (claims processed but no payments) remittances as needed and processes them with the same high priority as if it was cash.
• Posts accurately to the correct account the amount of patient payments received via hospital portal, vendors such as early out and collection agency or check/cash by mail or credit card transactions in the mail/phone or through payroll deduction.
• Payments or insurance recoups/credits that are not identified properly are tracked as required, researched via phone, email or portals with appropriate and thorough documentation posted in the note section of either system and preferably resolved the same day so they can be posted to the correct account but at the very least, within 24 hours of receipt, or posted to a unapplied account that is managed weekly and reported on monthly in an effort to resolve and transfer payments from this general category to the specific account level ASAP.
• Keys non patient revenue to the appropriate General Ledger (GL) upon arrival or within 24 hours of receipt received from Finance or insurance companies researching when necessary and posting to an unapplied account if and when designation is not yet available.
• Runs appropriate reports for quality control purposes (QA) to double check contractual amounts posted. In particular, posts contractual for insurance secondary paper remittances based upon the account balance less patient portion and not based upon the remit. Those remits that are electronic, run a QA report to catch the over contractualizations causing credit balances.

Qualifications:

• Ability to read, analyze, and interpret governmental regulations and documents such as safety rules, operating and maintenance instructions, and procedure manuals.
• Ability to write routine reports and correspondence.
• Ability to plan, organize, and prioritize work in a multi-task environment where interruptions may be frequent.
• Ability to maintain strict confidentiality as defined by hospital policy.
• Ability to type, operate a computer, and a familiarity of medical terminology

Shift: Day
Ref Code: 1623

Contact Information: Dawn Kreft, Employment Coordinator – Human Resources
Email: dkreft@woodlawnhospital.com
Phone: 574-224-1102