Nuvance Health has a network of convenient hospital and outpatient locations — Danbury Hospital, New Milford Hospital, Norwalk Hospital and Sharon Hospital in Connecticut, and Northern Dutchess Hospital, Putnam Hospital Center and Vassar Brothers Medical Center in New York — plus multiple primary and specialty care physician practices locations, including The Heart Center, a leading provider of cardiology care, and two urgent care offices. Non-acute care is offered through various affiliates, including the Thompson House for rehabilitation and skilled nursing services, and the Home Care organizations.
Summary: Maintains accurate and timely claim submission for designated groups of accounts by payer. Insures that all claims are compliant with State and Federal billing regulations and contractual obligations. Collects cash from third party payers and patients. Expedites inquires by mail or phone as related to the designated group of accounts. Insures accurate and timely application of cash received. Processes statements to insure an effective billing system.
Responsibilities:
Accurate, timely and compliant claim submission.
Confirmation of electronic and hard-copy billing of any delinquent claims. Rebilling & follow-up of all delinquent claims.
Responds to all patient and payer inquiries, denials, correspondence & telephone inquires.
Maintains all reports (contract management) files and records as needed; i.e., medical records, referrals, pre-certification letters etc.
Advises other areas of updated insurance information and claim denials; i.e., registration.
Follows through with education of rules and regulations in the managed care system, as well as, State & Federal guidelines.
Adjusts account balances to specific account needs; i.e., capitated labs.
Maintains Contract Management reporting (i.e., payment errors, carve out billings ) and updates any information as needed or requested by supervisor.
Applies cash received to appropriate accounts. Refunds all overpayments as necessary.
Maintains departmental policies and procedures.
Adheres to all policies and procedures related to compliance with all federal & state billing & collection regulations & third party contractual obligations.
Fulfills all compliance responsibilities related to the position.
Other information: Required: Data entry. Customer service experience required. Minimum Experience: six months Desired: Experience in billing and collections or Medical Office/Healthcare experience preferred.
Location: Summit-100 Reserve Rd
Work Type: Full-Time
Department: Patient Accounting
Grade: S3
Salary Range: $16 – $21
Education: Essential: * HS Graduate or Equivalent Working conditions: Essential: * Significant manual skills / motor coord & finger dexterity * Little or no potential for occupational risk * Sedentary/light effort. May exert up to 10 lbs. force * Generally pleasant working conditions.
EOE, including disability/vets.
We will endeavor to make a reasonable accommodation to the known physical or mental limitations of a qualified applicant with a disability unless the accommodation would impose an undue hardship on the operation of our business. If you believe you require such assistance to complete this form or to participate in an interview, please contact Human Resources at 203-739-7330 (for reasonable accommodation requests only). Please provide all information requested to assure that you are considered for current or future opportunities.