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Cape Cod Healthcare

Hyannis, MA
Job Code:
  • Information Technology
  • Financial Services
  • Healthcare
  • Administrative / Clerical
Cape Cod Healthcare
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Job Details

Perform accurate and timely account resolution.
  • Perform accurate and timely follow-up, reconciliation and resolution of outstanding account balances.
  • Analyze and resolve outstanding receivables utilizing remittance reports, payment advisories, explanation of benefits, etc.
  • Verify accuracy of third party payments.
  • Post contractual allowances where necessary.
  • Refer accounts for billing where appropriate, reassign eligible balances to self pay and/or 3rd party billing status.
  • Process third party payor denials and related correspondence in a timely and accurate manner.
  • Perform administrative and clerical functions including but not limited to typing, photo copying, filing, calculating, faxing, etc., as assigned.
  • Collaborate and interact with all departments to resolve edit errors.
  • Maintain job knowledge adequate to effectively carry out the responsibilities of assigned insurance (s) group including CPT, HCPC, ICD-9 coding, occurrence, condition, span and value codes in addition to modifiers.
  • Add and removes charge procedure codes, modifiers, and other codes, as directed by clinical department heads.
  • Maintain supporting documentation for all account changes with originating department sign-off.
  • Pursue other insurance information through eligibility verification and check claims status utilizing online access and individual insurance carrier websites.
  • Review billing, payment, and denial information utilizing a number of automated databases.
  • Identifies potential reason(s) for payment denial, initiates and follows through with appropriate remedial action.
  • Utilize third party denial management system to provide reports and workflow denials.
  • Perform follow-up activities on unpaid accounts through downloaded trial balances, internet insurance websites, and other reports and/or claim listings where appropriate.
  • Perform individual claim correction, adjustments, and cancels through online access to specific payors websites.
  • Calculate patient liability and perform system adjustments to support accurate patient statement billing as needed.
  • Respond to patient and/or insurer inquiries in a professional, timely, efficient and knowledgeable fashion, ensuring HIPAA and CCH guidelines are followed.
  • Monitor credit balance reports and performs analysis making appropriate claims adjustments and/or refunds as necessary.
  • Create and maintain logs and reports as needed to support Patient Account activities.
  • Assists the department and acts as a team member by covering for absences, training activities, etc. in support of hospital and departmental work activities.
  • Comply with departmental and organizational policies including but not limited to dress code, use of supplies, telephones and computers.
  • Adheres to work schedules and maintains a safe and orderly work area at all times, maintaining awareness of and compliance with safety policies and procedures.
  • Attends and participates in educational programs, in-service meetings, workshops, and other activities as related to job performance, job knowledge and state regulations.
  • Ability to analyze automated computer output
  • Performs other job related duties and assignments as requested.
Consistently provides service excellence to all patients, family members, visitors, volunteers and co-workers in a manner that reflects Cape Cod Hospital's commitment to CARES: compassion, accountability, respect, excellence and service.

  • Ability to read, write and communicate in English.
  • 2 years education beyond high school at a trade school, technical school or college in healthcare office practices, physician office practices, or financial services AND 1 year recent (within the past 5 years) experience using electronic billing or receivables systems OR minimum of 1 years recent experience (within the past 3 years) in a Medical Setting
  • Basic mathematics skills, and ability to apply skills, as demonstrated by successful passage of a timed business math test, using manual and calculator aided computations to solve problems.
  • PC skills, including Microsoft Excel, Word and Outlook, with a minimum of 6 months experience working with Meditech or similar information system on a daily basis.
  • Keyboarding skills at 35 WPM as demonstrated by successful passage of a timed test.
  • Successful passage of CCH A/R Resolution test OR 1 year recent (within the past 2 years) work experience in medical receivables resolution.
  • Successful passage of basic medical terminology course OR successful passage of the CCH Medical Terminology exam.

Schedule Details: 40 hours per week, 8a-4p Monday-Friday, occasional weekends and holidays
Organization: Cape Cod Hospital
Primary Location: Hyannis
Department: CCH-Revenue Cycle
Employee Classification: Regular-Regular
Shift: Day
Weekend Shifts: Occasional
Holiday Shifts: Occasional
Posting Start Date: Mar 23, 2018
Posting End Date: Ongoing
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