Cash Applications Specialist II bei Artesia General Hospital

Description

Job Summary:

The Hospital Cash Applications Specialist II is responsible for timely processing of payments, refunds, adjustments and balancing and reconciling all patient and insurance payments and recoupments for Artesia General Hospital and physician practices.

General Description:

Ensures that all insurance and patient self-pay payments, adjustments, and denials are posted to facilitate timely, accurate management of accounts receivable. Organizational, communication (written, verbal and personal), problem solving, prioritizing and decision-making skills are routinely used in everyday activities. There is minimum supervision, and appropriate initiative must be taken to complete projects by the deadlines given.

Essential Values-Based, Leadership and Management Competencies:

At Artesia General Hospital, our leadership and management practices are grounded in our core values, captured in the acronym S.E.R.V.I.C.E. These values are the foundation of all employee activities and guide us in fulfilling our Mission.

• Servant Leadership – Leading by serving others with compassion and humility. 

• Excellence – Striving for the highest quality in all we do. 

• Respect – Treating everyone with dignity and kindness. 

• Virtuousness – Acting with honesty, integrity, and accountability. 

• Innovation – Embracing new ideas to improve care and outcomes. 

• Community – Fostering collaboration to meet the needs of those we serve. 

• Education – Promoting learning and professional development. 

ESSENTIAL FUNCTIONS: 

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required.

• Receives and records all acceptable methods of payments received to the appropriate patient or non-patient accounts.

• Posts and reconciles electronic received insurance payments (RAP’s) accurately and timely.

• Posts and Balances payments received through mail from patients and insurance companies.

• Identifies and posts appropriate adjustments, discounts, and denials to accounts when warranted.

• Resolve and reconcile the unapplied account monthly.

• Post zero payments on a daily basis and forward information to the billing department as needed.

• Assists in the processing of patient insurance refunds.

• Reconciles daily payment batches with hospital deposits to ensure all insurance and self- pay payments are accounted for.

• Research and resolves any discrepancies in the daily payment reconciliation process.

• Archives and files all deposit documents appropriately and in a retrievable and accessible manner.

• Investigates unidentified payments and resolves them promptly.

• Assists in identifying and working credit balances.

• Meets all monthly and year end fiscal closing deadlines as they relate to the cash application process.

• Assist with clearinghouse ERA and EDI enrollments as needed.

• Works hand- in- hand with the billing team to maintain a healthy and consistent cash flow.

• Other special projects and duties as assigned.

ADDITIONAL RESPONSIBILITIES:

• Excellent communication and interpersonal skills. Prompt response to email and telephone calls.

• Detail oriented; ability to multi-task; organized and able to work in a fast-paced environment.

• A strong understanding of the receivable accounts process is fundamental; this means knowing the entire life cycle from billing to collections to reconciliation. 

• The ability to analyze financial data accurately is crucial. You’ll be spotting trends, identifying discrepancies, and making data-driven decisions about payment applications.

• Assist Business Office Lead/Supervisor/Manager/Director as required or assigned.

• Performs other necessary duties as required to meet the goal of providing exceptional customer service to the community and health system.

• Demonstrate awareness of age specific, cultural and spiritual practices of patients, staff and visitors.

• Understands the functional status and physical needs of patients, staff and visitors.

• Will treat all customers, coworkers, medical staff and the communities we serve with integrity and service excellence at all times as measured by documented communications to the Department Director.

• Will abide by the policies of Artesia General Hospital related to compliance.

• Will report to work on time as scheduled per the HR policy. Will be available for a full-time schedule. Will have flexibility to work evenings and weekends as necessary to meet deadlines.

• Will attend weekly and monthly meetings as required.

• Will complete annual education and training requirements.

• Adheres to departmental standards and personnel policies by demonstrating professional demeanor in conduct and appearance.

• Ability to work remotely, from a home-based environment with desk, desk chair, computer, adequate lighting, and access to cable internet.

KNOWLEDGE/SKILL/ABILITIES:

• High school diploma or equivalent required.

• 1 - 3 years of experience in the healthcare setting (Hospital and/or medical office) working with insurance claims processing involving CPT, HCPCS, ICD-9CM, ICD-10CM and CMS regulations.

• Familiarity with CMS1500 and UB04 claim form completion.

• Strong analytical, oral, written communication skills.

• Familiarity with health insurance and other third-party billing practices and guidelines.

• Proficient in Microsoft Word, Excel, Access, Outlook, and the like.

• Bilingual in Spanish and English a plus.

• Must be able to assess situations, identify issues/problems and prioritize duties.

• Reasoning Ability: Uses personal experience, knowledge and other outside resources to make logical decisions to solve problems.

• Utilizes Time Management and Organization skills.

• Attention to detail is accurate and completes principal accountabilities timely.

• Professionalism.

• Understanding of Medical Terminology.

• 10 Key experience.

AGE-RELATED COMPETENCIES: Demonstrates the basic knowledge and skills necessary to identify age-specific patient needs appropriate for this position.

Information Management: Treats all information and data within the scope of the position with appropriate confidentiality and security.

Risk Management/Quality Management/Safety: Cooperates fully in all Risk Management, Quality Management, and Safety Activities and Investigations.

MINIMUM POSITION QUALIFICATIONS: 

• Education – High school diploma or equivalent.

• Work Experience - Minimum 3 years of experience in the healthcare setting (Hospital and/or medical office) working with insurance claims processing involving CPT, HCPCS, ICD-9CM, ICD-10CM and CMS regulations.

• Minimum 3 years of experience in the healthcare setting (Hospital and/or medical office) working in the payment posting field.

• Familiarity with CMS1500 and UB04 claim form completion.

• Familiarity with working patient credit balances and researching those accounts to resolve any outstanding credits.

• Strong analytical, oral, written communication skills.

• Familiarity with health insurance and other third-party billing practices and guidelines.

• Proficient in Microsoft Word, Excel, Outlook, and the like.

• License/Certification – None

ENVIROMENTAL CONDITIONS: Work environment consists of daily patient contact, which may include exposure to blood, or other body fluids.