Billing and Insurance Specialist Job In Lodi, California
Reimbursement AnalystNext Steps... Apply Now
TITLE: Reimbursement Analyst
REPORTS TO: Patient Financial Services Director
SUMMARY: Responsible for assisting in the analysis, identification and preparation of data related to denial prevention. Produces and processes reports to identify potential statistics to improve reimbursement and enhance billing and collection procedures. Demonstrates the ability to identify and meet department growth opportunities and needs. Competent in providing services for the culturally diverse population Adventist Health Lodi Memorial serves. Exhibits work performance that embodies our mission, vision, and values.
EDUCATION, TRAINING AND EXPERIENCE:
1. Bachelor of Arts Degree.
2. Knowledge of healthcare billing and collection including contract reimbursement terms.
3. Strong interpersonal, listening, and communication skills both verbally and in writing.
4. Advanced proficiency in Microsoft Office Suite of programs (Word, Outlook, Excel, PowerPoint), office machines, software and computer applications.
5. Ability to exercise good judgment and independent thinking skills.
1. Two to three years of experience with patient financial processes.
2. Cerner/Revworks experience.
MAJOR DUTIES AND RESPONSIBILITIES:
1. Takes a lead role in working with staff members at all levels to resolve and minimize claim denials.
2. Audits patient accounts for compliance.
3. Acts as a liaison between hospital personnel and payers.
4. Production of statistical reports to identify trends.
5. Performs the tasks necessary in the daily work queue to ensure that all tasks are performed in a timely manner.
6. Participates in and coordinates the education and training of Patient Financial Services staff.
7. Works in a team setting to identify problems and participates in instituting an improvement process.
8. Participates in the Denial Management Committee and reports trends for improved cash flow.
9. Practices good organizational skills in all functions to meet timelines and goals.
10. Demonstrates flexibility in performing special projects and other duties as directed by the Patient Financial Services Director to maintain operational efficiency.
1. Conducts hospital and department business in an ethical and lawful manner, and willing to report any knowledge of real or potential fraud or abuse according to the Lodi Health Compliance Code of Conduct.
2. Will not use or disclose individually identifiable health information of patients over and above that which is minimally required to perform your assigned position responsibilities
1. Typical non-smoking office environment. Work is both sedentary and standing.
2. Works in clean, well lighted building with a central air conditioning and heating system.
3. Requires pedestrian trips to other buildings within the hospital facilities. Vehicular trips to hospital facilities outside normal walking distance may be required on occasion.
4. Potential exposures to infectious diseases blood borne pathogens and hazardous materials and substances.
1. Must have physical capacity and manual dexterity for walking, bending, stooping and reaching.
2. Must have sufficient dexterity to operate a personal computer, typewriter and small business machines.
3. Required to lift, push, and pull up to 25 pounds without assistance.
Duties and responsibilities may be added, deleted, or changed at any time at the discretion of the Director of Patient Financial Services or designee, formally or informally, either verbally or in writing.
Lodi Health is a private, not-for-profit health system that strives to improve the quality of life in the community it serves - both in and beyond its walls. As a non-profit, unaffiliated health system, Lodi Health is able to reinvest in talent, technology and physicians to ensure patients receive quality and very personal care.
Since April of 1952 when the Lodi Memorial Hospital's doors first opened, until today, Lodi Health has evolved to meet the changing community's need. In 1952, there were 14,000 residents in Lodi. Today there are 65,000, and the area served beyond Lodi's boundaries has grown to more than a quarter million people.
Over the last 63 years, a lot has changed at Lodi Memorial Hospital. New buildings and wings have been erected. New technologies, like robotic-assisted surgery, have been introduced. Quality physicians and dedicated nurses have worked round the clock. Lodi Memorial Hospital became Lodi Health to encompass all of its services that provide the quality health care you need with the compassion and personal attention you want from the first day of your life and every day thereafter.
Our vision is to be the first choice for health care by providing the highest level of quality, care access, wellness and affordability through partnerships with patients, staff, physicians and the community we serve.
Now, Lodi Health is pleased to join the Adventist Health family, which allows for even greater service in Lodi and its surrounding communities.