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Specialist-Reimbursement - AC BHME Memphis

Job ID: 11012
Job Category: Finance and Accounting
Job Type: Non Clinical
Work Type: Full Time
Work Schedule: Days
Facility: BHME-Memphis
Location: Memphis, TN

Summary

Maximizes collections of accounts receivable through benefits verification and communication of authorized services as appropriate, accurate submission of claims, secondary billing, and timely follow-up of outstanding accounts receivable to assist entity in meeting financial targets or goals. Performs other duties as assigned.

Responsibilities

  • Prepares and submits accurate invoices to payors following established policies and procedures to ensure payment for services and supplies.
  • Receives payor information, verifies coverage, and secures authorizations as required by each payor source and communicates with all appropriate persons as determined by policy.
  • Resolves denials, inaccurate payments and non-payments by reviewing available documentation and taking appropriate action to collect or adjust the account.
  • Prepares write-offs and adjustments according to established policy to maintain accurate accounts receivable.
  • Resolves charges on hold by timely review of billing releases and orders tracking documentation and taking appropriate action to secure release of bills for submission to payor.
  • Evaluates expiring prior authorization of services, taking necessary action with payors, physicians offices, and clinicians to extend authorization or to discontinue services.
  • Reviews medical documentation and/or claims release prior to billing to ensure corporate compliance with billing regulations (Medicare, Medicaid, state programs, etc.).
  • Completes all assigned goals.


Requirements, Preferences and Experience

Education

Minimum: Skill in communicating clearly and effectively using standard English in written, oral and verbal format to achieve high productivity and efficiency. Skill to write legibly and record information accurately as necessary to perform job duties.

Experience

Preferred: Billing/Accounts Receivable experience, healthcare preferred.

Minimum: One year business experience.

Special Skills

Preferred: Knowledge of medical terminology, basic Microsoft Office, Excel, and Word computer skills.

About Baptist Memorial Health Care

At Baptist, we owe our success to our colleagues, who have both technical expertise and a compassionate attitude. Every day they carry out Christ's three-fold ministry-healing, preaching and teaching. And, we reward their efforts with compensation and benefits packages that are highly competitive in the Mid-South health care community. For two consecutive years, Baptist has won a Best in Benefits award for offering the best benefit plans compared with their peer groups. Winners are chosen based on plan designs, premiums and the results of a Benefits Benchmarking Survey.

At Baptist, We Offer:
  • Competitive salaries
  • Paid vacation/time off
  • Continuing education opportunities
  • Generous retirement plan
  • Health insurance, including dental and vision
  • Sick leave
  • Service awards
  • Free parking
  • Short-term disability
  • Life insurance
  • Health care and dependent care spending accounts
  • Education assistance/continuing education
  • Employee referral program

Job Summary:
Position: 5334 - Specialist-Reimbursement
Facility: BHME-Memphis
Department: AC BHME Memphis
Category: Finance and Accounting
Type: Non Clinical
Work Type: Full Time
Work Schedule: Days
Location: US:TN:Memphis
Located in the Memphis metro area
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