Offer summary

Qualifications:

High School Diploma or GED equivalent required; Bachelor's degree in Accounting, Business, or Health Related Field preferred., 1+ years of clerical experience and 1+ years in Medical Patient Accounts or Financial Services preferred., Certifications such as Certified Clinical Account Technician (CCAT) or Certified Patient Account Technician (CPAT) are advantageous., Knowledge of third-party payer procedures and compliance standards is essential..

Key responsabilities:

Process and review inpatient and outpatient medical claims accurately according to payer specifications.

Conduct timely follow-ups on claims and track submission issues for resolution.

Maintain system documentation for claim processing and provide customer service regarding patient responsibilities.

Participate in departmental performance improvement and quality control activities.

Job description

Current Employees:

If you are a current employee, please apply via the internal career site by logging into your Workday Account and clicking the "Career" icon on your homepage.

Primary Location

Rapid City, SD USA

Department

CS Patient Financial Services

Scheduled Weekly Hours

Starting Pay Rate Range

$16.40 - $20.50

(Determined by the knowledge, skills, and experience of the applicant.)

Job Summary

Perform duties necessary to ensure the proper interpretation, processing, recording, approval and payment of inpatient and outpatient medical claims. Accurately reviews information for processing claims into a computerized system in accordance with the primary payer specifications and billing guidelines.

Monument Health offers competitive wages and benefits on qualifying positions. Some of those benefits can include:

*Supportive work culture

*Medical, Vision and Dental Coverage

*Retirement Plans, Health Savings Account, and Flexible Spending Account

*Instant pay is available for qualifying positions

*Paid Time Off Accrual Bank

*Opportunities for growth and advancement

*Tuition assistance/reimbursement

*Excellent pay differentials on qualifying positions (extra pay for working evening, nights or weekends)

*Flexible scheduling

Job Description

Essential Functions:

Demonstrates application of compliance standards and payer specific data to properly file claims and ensures prompt, appropriate reimbursement of services and supplies billed to third parties and appropriate payment of services and supplies due from patients, as evidenced by documentation, observation and feedback.
Demonstrates a working knowledge of third party payer procedures including, but not limited to: Commercial Payers, Veterans Administration, worker' compensation, third-party liability, county payers, and all other third party contractual agreements as required.
Conducts timely follow up of claims. Use tools provided to track and trend patterns of claim submission issues that might require Compliance and Charge master staff to resolve, or HIPAA transaction code set review. Research payer requirements and offer suggestions to leadership for claims submission issues.
Maintains and updates appropriate system documentation to provide information regarding claim processing to internal or external customers.
Identifies unresolved requests of patient responsibility and transfers account to self pay. Performs duties and provides best customer service using behaviors that demonstrate responsibility and accountability.
Participates in departmental activities related to performance improvement and quality control.
Demonstrates a working knowledge of denial follow up and first level appeals.
All other duties as assigned.

Additional Requirements

Required:

Education - High School Diploma/GED Equivalent in General Studies

Preferred:
Experience - 1+ years of Clerical Experience; 1+ years of Medical Patient Accounts/Financial Services Experience
Education - Bachelors degree in Accounting, Business, Health Related Field
Certifications - Certified Clinical Account Technician (CCAT) - Accredited University or accredited training professionals; Certified Patient Account Technician (CPAT) - Accredited University or accredited training professionals

Sedentary work - Exerting up to 10 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects, including the human body. Sedentary work involves sitting most of the time.

Job Category

Finance

Job Family

Insurance Services

Shift

Employee Type

Regular

15 Corporate Services Division

Make a difference. Every day.

Monument Health is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or protected Veteran status.