Job description
Overview
How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives.
Responsibilities
Under the direction of the Manager of Account Resolution, the Account Resolution Representative II assists with planning and coordinating HB Accounts Resolution follow up activities for an account receivable portfolio of ~ approximately $375M-$500M, including, but not limited to collaboratively working with their Team Lead, Manager, and assisting with training, employees, as circumstances dictate. The Account Resolution Representative II will assist with the development of strategies for establishing a continuous improvement work environment, ensure eligible accounts are reviewed, appealed, escalated or adjusted within the designated payer time frames and are documented appropriately in the patient accounting system. As well as providing educational support in a variety of departmental and individual settings. The role requires data analysis, trending analysis, and educational capabilities regarding payor and revenue cycle business related processes.
This role requires a versatile and well developed actionable understanding with demonstrated knowledge of billing, collections, denial management, contractual provision interpretation and provider / payor appeal requirements. In addition to a strong understanding and capability of common business technologies such as MS Office, Excel, PowerPoint, Word and Outlook to perform and communicate the assessment and analysis of multiple acute care and LTAC facility accounts receivable trending and findings is needed. The core role focus of this position is to ensure that accounts are brought final resolution through reimbursement for services and to mitigate financial losses through solid operational execution, development and conformity to defined Policies and Procedures. The Account Resolution Representative II must possess the ability to assist with developing and documenting action plans for quick resource deployment, communicate timely with leadership to understand the specific reasons for payment delays. The role requires the ability to effectively and efficiently communicate both orally and in writing to leadership, multi-task, meet deadlines, adhere to organizational policies and procedures. In addition, the Account Resolution Representative II will assist with additional Revenue Cycle related tasks and duties as assigned.
Qualifications
Required Minimum Education
- High school diploma or equivalent required
- Certified Advanced CPAR or equivalent is strongly preferred
Required Minimum Experience:
- Experience as an Account Follow-up Representative I or a minimum of two (2) years in hospital patient financial services or related area.
- Must have a thorough understanding of Governmental, i.e. Medicare, Medicaid and / or Non-Governmental, i.e. Commercial: healthcare revenue cycle functions, PFS operations, regulations and reimbursement methodology, denials management, payor technical denial appeals and a proven track record of successful performance within the Revenue Cycle is required
Required Minimum Skills
- Strong interpersonal, mathematical, analytical, computer, problem solving and writing skills, with a “take charge” attitude. Must be comfortable interacting with insurance providers, physicians and leadership. . Must be able to perform a wide variety of tasks that require independent judgment, ingenuity, and initiative. Competent with MS Word, PowerPoint, and MS Excel is required as critical analysis will be conducted using this technology.
- establish a climate to achieve optimal performance levels and maintain a cohesive work team
- work efficiently under pressure and deal effectively with constant change
- operate a computer and related applications
- apply appropriate supervisory, management and leadership techniques in an operational setting
- work independently and take initiative
- demonstrate a commitment to continuous learning
- deal effectively with difficult people and/or difficult situation
- willingly accept responsibility and/or delegate responsibility
- set priorities and use good judgment for self and staff
We’d like to invite you on a career journey like no other! In return for your contributions, we’ll help you make the most of all life’s moments – on and off the job. Wellstar Total Rewards is designed to provide for your total well-being, including: Your Wellness, Your Pay, Your Future, Your Joy. We think it’s pretty simple – we care for our team members and our team members care for the community.
Make a difference in patients’ lives… and your own! Here, it’s more than healthcare – it’s CareerCare!
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