Medical Billing (Patient Accounting)

Additional Position Details: FTE: 1.000000 | Full Time | Primarily Monday- Friday, 0800-1700

Asante is more than a great hospital system in an amazing location. We are a community of passionate providers and service-focused caregivers who collaborate to deliver amazing patient outcomes; a place where titles don't matter as much as your creativity, drive, and passion. Our culture, values and people create an environment of sustained medical excellence. All three Asante hospitals have earned five stars from CMS for overall quality -- the top rating given. In fact, Asante accounts for three of the five Oregon hospitals to achieve this rare honor.

The Accounts Receivable Specialist performs account analysis and functions required to receive reimbursement from governmental and non-governmental insurance carriers in an efficient, productive and compliant manner following departmental policy and procedures. They also work proactively, assisting the public with medical financial responsibilities in a way which will provide continual success for the Asante organization.

As an Accounts Receivable Specialist at Asante, you will have the opportunity to:

• Consistently complete all standard and special monthly aging reports contributing to Asante's financial success by requiring reimbursement from insurance carriers in a timely manner. Check status of claims by telephone, insurance websites, MMIS, FISS, ePremis, and/or other means available. Maintains secure passwords with multiple insurance carriers for access to websites.
• Consistently complete weekly Medicare credit balance report. Adjust claims on the Medicare Florida Shared System as needed to resolve credit balances. Takes appropriate action on all Medicare and Medicaid credits within 45 days.
• Consistently complete review of daily late charge report to determine if Medicare or Medicaid accounts require adjustments to add or remove charges that were not reflected on the original claim submission. Provides information to Supervisor concerning departmental trends in late charges. (Late charges for all other carriers are worked by the Patient Account Reps).
• Review denial reports and take back reports for governmental and non-governmental insurance carriers, in electronic and other formats, & takes appropriate action on accounts. Review any vouchers, remittance advice and explanation of benefits given by the cashiering staff. Take appropriate action on accounts denied for non-covered service or procedure, no preauthorization, timely filing, coding issues and other line item denials.
• Review monthly status report from Medicaid Adjudication Service for Medi-Cal & Other States Medicaid accounts. Works line item denials and accounts with balances. Provides requested information to Medicaid Adjudication Service staff as requested.
• Distribute appropriate copies of vouchers, remittance advice and explanation of benefits to Patient Account Reps for items to be worked. This may include denials for missing medical records, chart notes, other carrier explanation of benefit copies, invalid Subscriber identification numbers, or additional information needed from the patient.
• Serve as the AR Specialist Lead or ARS Coordinator on monthly rotation.AR Specialist Lead will assist with task related issues in their area. ARS Coordinator will assign duties as needed to cover for vacations or absent staff.
• Monitor claim rejections for trends and issues, and reports findings to supervisor.

Education

• High school diploma, GED, or equivalent experience demonstrating the ability to effectively communicate as needed for the position is required
• Associate or Bachelor Degree, preferred

Experience

• Prior experience in medical billing or accounting/business office function is required

• Competitive starting wage
• Comprehensive benefits including medical, dental, vision, and wellness
• Excellent retirement package with up to 6% employer contribution
• Generous Earned Time Off
• Tuition reimbursement after one year of service

Asante is a local, community owned and governed, not-for-profit organization that provides comprehensive health care services to more than 550,000 people in a nine-county area of Southern Oregon and Northern California. It includes Asante Ashland Community Hospital in Ashland, Asante Rogue Regional Medical Center in Medford, Asante Three Rivers Medical Center in Grants Pass, Asante Physician Partners throughout the Rogue Valley, and additional health care partnerships. Virtually all medical specialties and services are represented within an organization dedicated to providing exceptional care. With over 5,000 employees, Asante's entities offer outstanding opportunities for career advancement and professional growth. At Asante your work positively impacts your family, friends, neighbors and the community. Experience the difference in how you work, how you live and how you connect.

At Asante we are defined by our values - traits that guide us as we serve patients and the community:

Excellence - Respect - Honesty - Service - Teamwork

Asante is an equal opportunity employer. We are committed to employ and advance in employment women, minorities, qualified individuals with disabilities and protected veterans.