Ohio State University Physicians este grupul medical din spatele cabinetelor universitare de la Centrul Medical Wexner al Universității de Stat din Ohio. Medicii săi oferă îngrijire primară și de specialitate în locații ambulatorii din centrul statului Ohio, iar echipele sale furnizează și servicii de management și consultanță pentru organizații din domeniul sănătății. Activitatea grupului reunește îngrijirea clinică și expertiza operațională, iar colaborarea și dezvoltarea personalului îi susțin eforturile de a îmbunătăți sănătatea comunităților pe care le deservește.
Revenue Cycle Representative
Handle medical billing, insurance claims, reimbursements, and denials for Ohio State University Physicians. Monitor aging claims and resolve account issues to support timely reimbursement.
Descriere
- Process and validate invoices and insurance claims.
- Review reimbursements and follow claims through payment.
- Monitor claims across the revenue cycle and flag aging-account issues.
- Verify and correct patient, insurance, diagnosis, service, authorization, certification, and signature details.
- Address payer 277 rejections and denials, and follow up on outstanding issues.
- Analyze EOBs for denials and irregularities, take appropriate action, and resubmit claims.
- Investigate unpaid claims and resolve barriers to reimbursement.
- Research and correct missing or inconsistent patient information.
- Obtain additional forms or details needed for denied claims or special processing.
- Maintain work queues and invoices for collection follow-up.
- Reconcile accounts and adjust balances for denials, payments, adjustments, and other changes.
- Spot trends affecting revenue and raise issues with management.
- Contribute to denial prevention and resolution analysis.
- Track accounts-receivable research projects and report progress to the manager.
- Comply with government regulations and OSUP policies and procedures.
- Take on other duties and special projects as assigned.
Cerințe
- High school diploma or equivalent and at least two years of medical billing experience, or a comparable combination of education and experience.
- Experience handling denials and appeals.
- Knowledge of insurance carriers’ payment policies, procedures, and reimbursement amounts.
- Strong organizational and problem-solving abilities.
- Ability to manage competing priorities.
- Clear verbal and written communication skills.
- Ability to work under time pressure and respond to demanding requests.
- Ability to communicate effectively with people at all levels of the organization.
- EPIC, clearinghouse vendor, and imaging software experience preferred.
Beneficii
- Medical insurance
- Dental insurance
- Vision insurance
- Health reimbursement accounts
- Flexible spending accounts
- Retirement benefits
- Employee assistance program
- Paid time off
- Holidays
- Wellness program