Providence Health & Services Accounts Receivable Specialist - Post-Acute in Portland, Oregon
Providence St. Joseph Health is calling an Accounts Receivable Specialist to our location in Portland, OR.
This position is responsible for the timely and accurate billing and collections of payments from insurance carriers, agencies and others for equipment and services provided by Providence Senior and Community Services and Home and Community Services which could include the following service lines of Home Infusion/Specialty Pharmacy/Oral Dose, Skilled Nursing Facility, Home Health, Hospice, and Home Medical Equipment.
In this position you will have the following responsibilities:
Demonstrates competency in identifying and providing feedback regarding billing needs, recommending and implementing creative solutions to meet those needs, consistent with available resources, appropriate procedures, and internal controls for new and existing systems and coordinating efforts with other team members and departments.
Coordinates contacts with all third party representatives and others as required resolving issues related to outstanding claims.
Maintains knowledge of Medicare, Medicaid, and commercial payors rules and regulations by attending online seminars as directed by management and monitoring web sites to maintain regulatory compliance knowledge.
Maintains and/or notify appropriate personnel of all appropriate schedules needed to bill efficiently. May assist in planning for new or upgraded financial systems and coordinates the implementation process among the finance users, information services staff and other parties.
Retains and maintains all third party contract rates and associated billing codes to ensure maximum reimbursement to facility/agency.
Insures all appropriate regulatory requirements, including HIPAA, are incorporated into work practices in an effort to maintain regulatory compliance and promote the integrity of confidential/private data and patient information.
Maintains updated job standards list for assigned duties including detailed list of scheduled activities, deadlines, and order of completion to ensure coordination of workloads, volumes, staff changes and cross training.
Seeks out guidance when uncertain of a procedure, policy or standard operating practice and performs other duties as assigned.
Identifies process breakdowns as they occur, and remedies them or escalates them to a higher level.
This position acts as a resource to others within Providence Senior and Community Services and as such, does not routinely delegate tasks.
Key understanding of payment methodologies including, but not limited to, per diem billing, fee for service, resource utilization grouping, and Home Health episodic Perspective Payment System.
Ability to use pc based programs (Excel, Word and Outlook), automated billing systems, claim management software, fax, copier, printer, multi-phone line.
Other duties and responsibilities as assigned.
Required qualifications for this position include:
High school diploma or GED, or equivalent education/experience.
Minimum of two (2) years recent experience in a healthcare environment with an emphasis on reimbursement and collections.
Must have knowledge and experience with insurance contracts and/or Medicare/Medicaid Regulations.
Excel, Office and Word intermediate skills.
Ability to communicate clearly both verbally and in writing and must be able to organize variable workflow volume.
Understand medical terminology, ICD10, CMS 1500 and uniform billing.
Ability to work in a fast-paced, high volume environment.
Preferred qualifications for this position include:
- College level courses in medical front office/medical billing
About the department you will serve.
Providence Strategic and Management Services provides a variety of functional and system support services for all eight regions of Providence Health & Services from Alaska to California. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise.
We offer a full comprehensive range of benefits - see our website for details
As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.
Providence Health & Services is a not-for-profit Catholic network of hospitals, care centers, health plans, physicians, clinics, home health care and services guided by a Mission of caring the Sisters of Providence began over 160 years ago. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.
Job Category: Billing/Insurance
Req ID: 222222