| JOB TITLE: Credit Balance Specialist II LOCATION: Buckhorn Office Building DEPARTMENT: Revenue Cycle WORK SCHEDULE: Days WORK TYPE: Full Time JOB SUMMARY: Provides the necessary functions to bill, collect, analyze, and adjudicate all hospital and professional accounts and functions within the Geisinger Health System. This position executes and performs programs to insure efficient operations of the Geisinger Health System Revenue Management program in order to resolve credit balances to support GHS operations and strategic initiatives. In the position of Revenue Management Credit Balance Specialist, responsibilities include resolving credits for all patients and third party insurance payers, cash application, adjudicating, identifying, analyzing and associated with approximately $30 million of hospital and professional accounts.
Reports to the Revenue Cycle Credit Balance Manager. MAJOR DUTIES AND RESPONSIBILITIES: *1. Performs all hospital and professional credit balance for various payers and cash application functions within the revenue management to include, but not limited to hospital and professional billing, charge corrections, cash application, credit balance resolution, revenue enhancement and cash flow for the eighteen various service lines.
*2. Performs the above-mentioned activities of the revenue management to insure cost effectiveness and organizational efficiency. Furthermore, this position executes these functions within the service line structure and in regards to how their function inter-relates to the other revenue management functions including Patient Access, Medical Records, Hospital Billing and Collections, Professional Billing and Collections, Cash Application, Revenue Enhancement, Human Resources, Information Systems, Financial Reporting, Process Improvement, Charge Entry, Training, Corporate Finance, Customer Service, Practice Specialists and all of the various third party payers associated with the eighteen service lines.
*3. Communicates their functional activities to their Supervisor and/or Manager, the Senior Director of their respective functional area and revenue cycle management management of GHS as it relates to billing, insurance follow- up (collections), cash flow, cash application, revenue enhancement, organizational profitability, customer service, accounts receivable results and revenue management service line results.
4. Understands and strives to meet Revenue Management targets, decrease overall A/R over 90 days, increase cash and effectively works through and assists patients and/or providers with the Discounting Policies and/or Bad Debt Policies.
5. Advises management of any unusual development or operational problems within area of responsibility and make recommendations for process improvement within the department.
6. Gains and maintains a working knowledge of a minimum of two payers and CBT staff’s duties to be able to offer assistance to other co-workers as necessary.
*7. Provides training for new or established staff as assigned.
*8. Conducts research and follow-up activities on assigned accounts according to established procedures and time frames. Assists in maintaining control over aged accounts
9. Responsible for in-depth understanding of SMS patient accounting system, IDX patient accounting system and CRS Credit Resolution System.
*10. Responsible for maintaining a working knowledge of other Revenue Management related software, i.e. payer websites, ePremis, and tower
*11. Develops’, implements and directs various quality initiatives to insure continuous monitoring and improvements within the revenue management process of GHS. This includes performing overall departmental operating functions within pre-determined limits and within Freedom-To-Act guidelines to insure operational efficiencies and obtaining pre-determined performance targets.
*12. Facilitates of various technological initiatives in support of business process improvements with respect to all revenue management functions and the various service lines.
*13. Works in conjunction with other areas within the revenue management and GHS to insure coordinated activities with respect to revenue management credit balance AR/team needs.
14. Performs other duties as required or assigned by emergency or other operational reasons for which the employee is qualified to perform.
* Denotes essential job functions. COMPETENCIES AND SKILLS: Demonstrates strong mathematical skills.
Demonstrates excellent communication skills, strong organizational skills, interpersonal skills, and writing skills. Demonstrates the ability to work independently and as a member of a team.
Demonstrates an extensive understanding of billing, insurance reimbursement and credit balance resolution processes.
Demonstrates the ability to effectively communicate in a positive and team oriented environment. Demonstrates familiarity with multiple computerized applications (i.e. Siemens, IDX, Tower, Contract Manager,
Cadence, Epic, Electronic Medical Health Record, ePremise, NaviNet, Artiva, etc).
Performs all areas of job functions at a high accuracy rate; with minimal supervision.
Organizes work to effectively utilize time management and maintain workloads at a current status.
Demonstrates the ability to work well in a team atmosphere fostering a positive, professional relationship with all staff across department and company lines. EDUCATION AND/OR SKILLS: Demonstrates strong mathematical skills.
Demonstrates excellent communication skills, strong organizational skills, interpersonal skills, and writing skills. Demonstrates the ability to work independently and as a member of a team.
Demonstrates an extensive understanding of billing, insurance reimbursement and credit balance resolution processes.
Demonstrates the ability to effectively communicate in a positive and team oriented environment. Demonstrates familiarity with multiple computerized applications (i.e. Siemens, IDX, Tower, Contract Manager,
Cadence, Epic, Electronic Medical Health Record, ePremise, NaviNet, Artiva, etc).
Performs all areas of job functions at a high accuracy rate; with minimal supervision.
Organizes work to effectively utilize time management and maintain workloads at a current status.
Demonstrates the ability to work well in a team atmosphere fostering a positive, professional relationship with all staff across department and company lines. WORKING CONDITIONS/PHYSICAL DEMANDS: Work is typically performed in an office environment. The specific statements shown in each section of this description are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job. OUR PURPOSE & VALUES: Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities. KINDNESS: We strive to treat everyone as we would hope to be treated ourselves. EXCELLENCE: We treasure colleagues who humbly strive for excellence. LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow. INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation. ABOUT GEISINGER: Geisinger is a physician-led health system comprised of approximately 30,000 employees, including nearly 1,600 employed physicians, 13 hospital campuses, two research centers, and a 583,000-member health plan Geisinger is nationally recognized for innovative practices and quality care. Geisinger serves more than 3 million people in central, south-central and northeast Pennsylvania and also in southern New Jersey with the addition of National Malcolm Baldridge Award recipient AtlantiCare, A member of Geisinger. In 2017, the Geisinger Commonwealth School of Medicine became the newest member of the Geisinger Family. We offer healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners.* Perhaps just as important, from senior management on down, we encourage an atmosphere of collaboration, cooperation and collegiality. For more information, visit www.geisinger.org, or connect with us on Facebook, Instagram, LinkedIn and Twitter. ** Does not qualify for J-1 waiver. We are an Affirmative Action, Equal Opportunity Employer Women and Minorities are Encouraged to Apply. All qualified applicants will receive consideration for employment and will not be discriminated against on the basis of disability or their protected veteran status. *Domestic partner benefits not applicable at Geisinger Holy Spirit. |
