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Job Summary
Processes inpatient and outpatient claims to insurance companies, employers and patients. Follows claims through the payment cycle to insure timely and accurate payment by third party payers. Maintains an in-depth knowledge of payer regulations and reimbursement methodologies to assure accurate reimbursement.
Essential Functions
- Processes patient and insurance payments to maintain timely cash flow and accurate account balances. Meets audit expectations, as determined by department.
- Analyzes assigned accounts receivable portfolio and take appropriate action to ensure compliant, timely claim resolution.
- Ensures payer and governmental agency regulatory and compliance requirements are consistently followed and applied.
- Identify, verify, communicate and monitor applicable AR trends and issues. Identify and trouble shoot issues that impact claim processing delays.
- Demonstrates professional communication, including verbal and written.
- Adheres to department and role-specific policies, procedures and key-metrics.
Qualifications
- High School Diploma or equivalent
- Required
- Associate’s Degree related field
- Preferred
- 2 years of relevant experience related field
- Required
- Experience in revenue cycle
- Preferred
Primary Location
SITE
- Business Service Center West
- 4420 44th St
- Grand Rapids
Department Name
PFS Professional Specialty Billing
Employment Type
Full time
Shift
Day (United States of America)
Weekly Scheduled Hours
40
Hours of Work
8 a.m. to 5 p.m.
Days Worked
Monday to Friday
Weekend Frequency
N/A
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Corewell Health is committed to providing a safe environment for our team members, patients, visitors and community. That is why we require a drug-free workplace and various vaccinations as a requirement for employment.Corewell Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, gender, pregnancy, sexual orientation, gender identity or expression, veteran status, or any other legally protected category.An interconnected, collaborative culture where all are encouraged to bring their whole selves to work, is vital to the health of our organization. As a health system, we advocate for equity as we care for our patients, our communities, and each other. From workshops that develop cultural intelligence, to our inclusion resource groups for people to find community and empowerment at work, we are dedicated to ongoing resources that advance our values of diversity, equity, and inclusion in all that we do. We invite those that share in our commitment to join our team.If you are a qualified individual with a disability, you may request assistance in completing the application process by calling 616.486.7447. We are committed to granting reasonable accommodations in accordance with applicable laws.
People are at the heart of everything we do, and the inspiration for our legacy of outstanding outcomes, innovation, strong community partnerships, philanthropy and transparency. Corewell Health is a not-for-profit health system that provides health care and coverage with an exceptional team of 60,000+ dedicated people—including more than 11,500 physicians and advanced practice providers and more than 15,000 nurses providing care and services in 22 hospitals, 300+ outpatient locations and several post-acute facilities—and Priority Health, a provider-sponsored health plan serving more than 1.2 million members. Through experience and collaboration, we are reimagining a better, more equitable model of health and wellness.
