GENESIS HEALTHCARE SYSTEM
 

In order to fill our Mission of serving our community by helping each person achieve optimal health and well-being by providing compassionate, exceptional, and affordable healthcare services, all employees of Genesis HealthCare System must be committed to living the Genesis Mission and Genesis values of Compassion, Excellence, Integrity, Team, and Innovation. All employees must regard themselves as an ‘owner’ of Genesis and keep our patients at the center of everything we do - always. 

Position Details:

Work Shift:

Varied Shift (United States of America)

Scheduled Weekly Hours:

40

Department:

Patient Account Management

Overview of Position:

Bills accurate information to commercial payers according to established guidelines and government regulations. Works directly with payers, physician offices and others as necessary to resolve problems resulting in correct and timely reimbursement. Responds to patient inquiries in a responsible, professional and caring manner for quality customer satisfaction.

ESSENTIAL DUTIES
1.    Interprets reports accurately and works requested reports within time frame established.
2.    Utilizes all online technology and bills accounts electronically when possible based on availability and payer guidelines.
3.    Ensures all claims and processes are compliant with the rules and regulations of our government and third party payers.
4.    Follows appropriate guidelines for billing and follow up of accounts.
5.    Appeals accounts if denied due to billing related issue
6.    Will ensure that accounts are properly corrected both on hospital system as well as government  payer system when applicable (Medicare online-MITS)
7.    Works rejections/denials and work list timely to prevent timely write off’s.
8.    Bills secondary accounts timely when applicable.
9.    Checks payer websites subscribes to list serves where applicable and is accountable to obtain necessary information from the payer/website.  Uses information from website and other sources accurately and effectively.
10.    Works recoupment accounts according to instructions for specific recoupment projects and is timely in response.
11.    Enters denial information in the Denial System to accurately track all accounts that are not paid as expected.
12.    Notifies appropriate person/department to provide information for accounts that error for CCI edits and handles accordingly.
13.    Contacts medical records as necessary (i.e. diagnosis, coding, etc).
14.    Will be responsible for consecutive work-queues to ensure the accounts are being billed according to payer guidelines
15.    Performs other functions as assigned.

QUALIFICATIONS
1.    High school diploma or equivalent.
2.    Experience with healthcare insurance and/or government billing.
3.    Knowledge of Medicare/Medicaid billing reimbursement policies.
4.    Some knowledge of CPT and ICD 9/ICD 10 Codes.
5.    Knowledge and understanding of insurance denials and explanation of benefits.
6.    Excellent listening, verbal and written communication skills, with ability to deal occasionally with disgruntled individuals.
7.    Excellent interpersonal, decision-making, facilitation, conflict resolution and investigative skills.
8.    Ability to independently prioritize and focus on multiple tasks concurrently.
9.    Ability to work independently and under pressure in a complex and changing working environment.
10.    Ability to work effectively with physician offices, staff from hospital departments or any resource for denial resolution.
11.    Effective time management and organizational skills.
12.    Excellent computer skills and knowledge of computer software, including programs such as Word, Excel.

PATIENT CENTERED CARE & BEHAVIORAL EXPECTATIONS
1.    Living the Genesis Mission, Vision and Values
•    Performs work in a manner that is quality focused. 
•    Treats patients, co-workers, visitors and volunteers with courtesy, compassion, empathy and respect.
•    Results oriented and focused on achievement of objectives.
•    Acknowledges and responds to the diversity of people and the situation.
•    Encourages peers (others) to be owners of change.
•    Always makes the effort to anticipate and exceed customer needs and expectations.
•    Possesses the ability to engage others with patience and understanding.
•    Acts in a manner that creates positive first and lasting impressions.
•    Demonstrates the ability to own issues until they are resolved.

2.    Patient Centered Care  (patients/families, physicians, co-workers, all other internal/external customers)