Company Overview:
National Partners in Healthcare (NPH) is a progressive healthcare company specializing in anesthesiology. We partner with physicians and health systems to deliver high quality care, aligning synergies and best practices to achieve superior outcomes. As a leader in the industry, we believe in developing a foundation of trust, transparency, and excellence in everything we do. The success of our company has created excellent career advancement opportunities that support a healthy work/life balance.
Position Summary:
Posts payments to patient accounts; keys and verifies insurance and patient payments in accurate and timely manner. Researches and processes all unidentified payments. Identifies and reports to supervisor any payment problems and discrepancies.
Essential Duties and Responsibilities:
- Post insurance and personal payments to patient accounts; balance checks in imaging workflow environment
- Verify and write off any non-allowed charges billed to participating payers. Verify the patient responsibility
- Read and comprehend insurance company explanation of benefits
- Reconcile daily deposits to posted amounts; resolve discrepancies by appropriate department’s monthly deadline
- Post rejections from insurance companies
- Process refunds for all overpaid accounts, unidentified and misdirected payments
- Research in the imaging system and find the remits for the suspended payments
- Call insurance companies to obtain copies of remits for suspended payments
- Review and make corrections on the trainees’ batches as needed
- Look for the ERA files for the EFT payments and report the missing files to supervisor
- Identify the payor for the EFT payments and match them to the ERA files in the system, accurately. Identify and report the discrepancies in the ERA files to the supervisor.
- Maintains strictest confidentiality.
Non-Essential Duties and Responsibilities:
- Perform other duties as assigned.
Education/Licensing/Certification:
- High School graduate or equivalent
Experience:
- Minimum of (1) one year of experience in 3rd party billing. (2) two years preferred. experience in a healthcare business office, specifically collections and/or payment posting, is required. Working knowledge of Excel and Word is required.
Knowledge and Skills:
- Knowledge of organization policies, procedures and systems
- Good understanding of the revenue cycle
- Thorough understanding and working knowledge of payor contracts and payer reimbursement policies
- Strong analytical and problem-solving skills to identify trend and issues and ability to solutions to address issues
- Knowledge of contractual management practices
- Skill in computer applications including MS Word, MS Excel.
- Basic knowledge of managed care programs and billing requirements necessary.
- Analytical abilities required to identify and resolve underpayments relating to specific payers, coding issues, etc.
- Good mathematical skills a must.
- Skill in verbal and written communication.
- Skill in gathering and reporting information.
- Ability to work effectively with staff, physicians and external customers. Must display teamwork attitude and good inter-personal skills.
- Must have a pleasant disposition and high tolerance level.
- Ability to work independently with limited supervision.
- Familiarity with basic medical terminology and concepts required
- Knowledge of CPT, ICD-9, and ASA coding.
Skills Required
- High school diploma or equivalent
- At least one year of third-party billing experience
- Experience in a healthcare business office, specifically collections and/or payment posting
- Two years of third-party billing experience
- Working knowledge of Microsoft Excel and Microsoft Word
- Knowledge of revenue cycle processes
- Working knowledge of payer contracts and reimbursement policies
- Basic knowledge of managed care programs and billing requirements
- Familiarity with medical terminology and concepts
- Knowledge of CPT, ICD-9, and ASA coding
- Strong analytical, problem-solving, mathematical, verbal, and written communication skills
- Ability to work independently with limited supervision and collaborate effectively with internal and external stakeholders
What We Do
National Partners in Healthcare (NPH) is a national healthcare organization delivering best-in-class anesthesiology services. The company partners with physicians and health systems to deliver high-quality care, aligning synergies and best practices to achieve superior outcomes. NPH provides anesthesiologists and CRNAs with the expertise, resources, and long-term sustainable solutions needed to grow their medical practices while maintaining their clinical autonomy and focus on patient outcomes.
