Job ID: 0008TQ

Tupelo

Administrative Support - BUSINESS SERV-BILLI

At North Mississippi Health Services, our mission is to “continuously improve the health of the people of our region.” Our vision is to “provide the best patient and family-centered care and health services in America.” We believe that fulfilling our mission and vision calls us to embrace the best people that form incredible connections to our patients and families.
We take pride in celebrating everything that makes you uniquely you – your talents, your perspectives, and your passions. At North Mississippi Health Services, we believe in connecting your passion with a purpose. When you are part of our team, you know what connected feels like.
#WhatConnectsYou
#NMHSConnections

Billing & Follow Up:

• Process Billing by receiving, interpreting, processing, and submitting through various edits to third party payors billing electronically and hard copy format.
• Billing follow up by contacting third party payers or accessing payer websites/provider portals to determine payment expectation and resolve any problem on the claim.
• Information communications and processing by interpreting and processing third party payor and patient inquiries in an accurate and timely manner to expedite payment.
  Denial Management:
• Manage denial receivable to resolve accounts
• Develops strategy for appeal, appeal follow-up and/or reprocessing accounts
• Analyze denials to determine reason they occurred
• Identifies trends and reports significant and recurring issues along with possible solutions to Denials Management Supervisor and Billing Manager
• Takes corrective action through systematic and procedural development to reduce or eliminate payment issues
  Contract Management:
• Familiarity with payer methodologies and the ability to communicate with NMHS staff
• Manage paid claims to resolve underpaid accounts
• Develops strategy for appeal, appeal follow-up and/or reprocessing accounts
• Analyze underpayments to determine reason they occurred
• Identifies trends and reports significant and recurring issues along with possible solutions to the Denials and Underpayment manager.
  Communication:
• Professionally and effectively communicates with third party carriers, vendors, and hospital contacts to promote contractual compliance
  Liaison:
• Contacts insurance companies regarding denial, underpayments or rejection issues
• Serves as liaison between payers and hospital departments/physician offices or patients in resolving denials and/or underpayment issues
  Reporting:
• Assists in preparation of monthly denial reports and other denial reports as requested
• Assists in preparation of monthly variance reports and other variance reports as requested.
  Regulation:
• Adheres to NMHS/NMMC Policies/Procedures/Guidelines.
• Complies with applicable Local/State/Federal policies/procedures/guideline/regulations/laws/statues.
  Job Knowledge:
• Bachelors degree in business, coding or equivalent field required; with a minimum of 2-year Claims, Billing/ Follow-Up, or Revenue Cycle experience required. Willing to consider 6 yrs Claims, Billing/Follow-Up, or Revenue Cycle experience beyond minimum requirement in lieu of degree.
• Experience/knowledge of managed care reimbursement methodology including ICD-10, CPT-4 and/or HCPCS and DRGs, required
• Ability to research, analyze and communicate payer trends to identify reimbursement and training issues.
• Excellent analytical and problem-solving skills required
• Good organizational and communication (written and verbal) skills; required
• Computer skills with strong Microsoft Office, Outlook, Third Party Payer websites; preferred
• Excellent interpersonal skills; required.

You must have one of the following combinations to apply:

• Bachelors of Business Related Field
• Bachelors of Business