Provide training, feedback and assistance to hospital clinic staff relating to pre-visit revenue cycle impacting processes, including demographic and insurance entry/information, patient TOS payment collection, eligibility verification, authorizations and provider credentialing. Oversee and perform bank/payment reconciliation/balance processes, as well as any clinic deposit and cash 2reconciliation processes. Periodically review clinic charge posting activities for compliance and adherence to accepted practices and documented processes, as well as assist in posting hospital clinic charges where responsibility is designated. Review/respond to/resolve claim scrubs, front-end denials, back-end denials, and appeals where responsibility is designated, including providing training, feedback, and assistance to hospital clinics in preventing the recurrence of problematic claims. Provide PMDS and hospital clinics with requested feedback, respond to general inquiries, process paper-based requests, assist with/locate missing EOBs, post patient payments, assist with patient billing phone calls, and reconcile patient bad addresses/returned mail. Assist with insurance/patient refunds processing and reconciliation between accounting and PMDS, including reviewing refunds lists, obtaining check numbers for refund checks processed, and assisting in the overall unapplied credits process. Oversee and monitor 3rd party payer/provider/department enrollment processes and ensure timely communication of changes/updates to hospital clinics, PMDS and other impacted parties. Collaborate with PMDS and other LifePoint hospitals/corporate departments to disseminate best demonstrated practices. Ensure compliance with all relevant regulations, standards, and laws. Work on special projects, as needed.

CPC - Certified Professional Coder - Required

Requires critical thinking skills, decisive judgment and the ability to work with minimal supervision.

Must be able to work in a stressful environment and take appropriate action.

Technical proficiency with computers, Microsoft Office, and medical software systems (PM/EHR).

Leadership and training skills and abilities.

Minimum education High school diploma or equivalent 

Associate or bachelor's degree Preferred. 

About Southwestern Medical Center

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