Tier 1 Business Services Specialist II

Posted 7 Hours Ago
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Cookeville, TN, USA
In-Office
Junior
Healthtech
More than a century of world-class orthopaedic care.
The Role
Manage assigned patient accounts from charge entry to final resolution. Verify/update insurance and demographics, rebill charges, review eligibility, resolve patient balances, set payment plans, process refunds, follow up on aging accounts, report denial trends, and coordinate precertifications and claim edits.
Summary Generated by Built In

Position Summary

Responsible for all aspects of assigned patient accounts after charge entry to final resolution

Essential Functions Statement(s)

  • Verifies and updates insurance information and demographics
  • rebills charges when insurance corrections are made 
  • Keeps up with changes in billing and pre-cert guidelines (including LCD's)
  • Reviews insurance eligibility
  • Determines and reviews financial responsibilities and insurance coverage with patients
  • Resolves patient balance related questions
  • Reviews surgery costs and establishes payment plans for patient portion
  • Reports denial trends to coders and managers 
  • Completes charge entry 
  • Processes patient and payor refunds 
  • Reviews insurance eligibility and rejections/errors 
  • Follows-up on aging buckets 
  • Identifies accounts for referral to outside collection agency
  • Edits claim holds
  • Keeps up with changes in payor processes and reports them to coordinator for appropriate action
  • Obtains all precertification
  • Responds to correspondence from payors and patients
  • Regular and predictable attendance
  • Ability to work in a cooperative manner with others
  • Performs other duties as assigned 
SKILLS & ABILITIES

Education: High School Graduate or General Education Degree (GED)

Experience: Previous healthcare billing experience is required

Computer Skills: Must be computer literate. Basic computer skills required. Must be able to type.

Campbell Clinic Benefit Summary: 

 

Campbell Clinic offers a lucrative benefit package to support employees and their families.

 

  • Medical / Dental / Vision Insurance
  • HRA Option
  • Flexible Spending Account 
  • Basic Life Insurance 
  • Voluntary Life Insurance Option
  • Long-Term Disability
  • Voluntary Short-Term Disability 
  • Accident Insurance 
  • Critical Illness Insurance
  • 401(k) Plan Matching + Profit Sharing 
  • Employee Assistance Program 
  • Paid Time Off 
  • 8 Paid Holidays 

Skills Required

  • High School Graduate or GED
  • Previous healthcare billing experience
  • Computer literate with basic computer skills
  • Ability to type
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The Company
HQ: Germantown, Tennessee
499 Employees
Year Founded: 1909

What We Do

Campbell Clinic is recognized as a national leader in sports medicine, pediatric orthopaedics, joint replacement, orthopaedic oncology, physical medicine and rehabilitation, and surgery of the hand, hip, foot, knee, shoulder and spine. We care for patients throughout their life, treating congenital issues as well as bone and joint problems affecting senior adults.

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