Sioux Falls, South Dakota, South Dakota
Linthicum Heights, Maryland
Posted: 07-Jan-25
Location: Denver, Colorado
Internal Number: R9354
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Department
Billing and CollectionsJob SummaryUnder general supervision, the Specialist ensures optimal reimbursement for hospital or provider billing on inpatient and outpatient accounts. Provides customer service, billing, timely follow-up, cash application processes, reconciling payer remittance, denial management and appeal functions for claims to government or grant funded programs, worker's compensation, commercial insurance. Provides financial guidance on self-pay accounts. Interprets explanation of benefits. Investigates delinquent accounts for legal liability. Acts as liaison support between the Hospital and Physician Business Services departments and third-party payers and other Denver Health departments. Utilizes various software applications and information systems to perform work processes.
Essential Functions:
- Completes claims submissions, performs review of accounts, ensure that work performed is accurate and complete. Consistently documents contact with debtor/insurance and/or any other content to the account using appropriate methods. Reviews account information and makes necessary changes. Researches, corrects, and resubmits claims within the mandated time frames to avoid loss of revenue. Initiates collections by contacting third party payer/debtor or designated representative. (40%)
- Returns assignments within the appropriate timeframe and with suggestions for resolution or process improvement. Completes worklists as assigned. Work product is consistently of high quality. Staff QA?d weekly and must be at 97% or higher. (20%)
- Uses billing systems efficiently and appropriately. Follows and understands actions needed to correctly effect patient accounts with the Siemens Invision system. Utilizes the imaging system to perform needed account research; able to scan, import and export if needed. Uses eligibility software to ensure the correct payer is billed. (15%)
- Processes accounts transactions accurately that involve transfer of charges, combining accounts, or manual adjustments. (10%)
- Processes and responds to incoming correspondence from insurance carriers, patients, and other Denver Health departments to move the accounts toward resolution. (10%)
- Identifies and communications existing or potential problems to supervisor in a timely manner. Offers constructive actions in problem resolution. (5%)
Education:
- High School Diploma or GED Required
Work Experience:
- No previous experience required.
Licenses:
Knowledge, Skills and Abilities:
- Knowledge and understanding of insurance benefit plans and explanation of benefits.
- Have current knowledge of regulatory requirements and codes.
- Skill sets to include 10-key by touch, typing a minimum of 25 words per minute (WPM) and, basic skills in word processing and spreadsheet applications.
- Ability to prioritize work activities with minimal supervision, in an individual and team setting.
- Strong written and verbal communication skills, analytical thinking, high level of computer accuracy, and organization and problem solving skills.
- Ability to utilize various software applications and information systems to perform work processes.
- Ability to adapt easily to change.
Shift
Days (United States of America)Work Type
RegularSalary
$21.82 - $29.53 / hrBenefits
Outstanding benefits including up to 27 paid days off per year, immediate retirement plan employer contribution up to 9.5%, and generous medical plans
Free RTD EcoPass (public transportation)
On-site employee fitness center and wellness classes
Childcare discount programs & exclusive perks on large brands, travel, and more
Tuition reimbursement & assistance
Education & development opportunities including career pathways and coaching
Professional clinical advancement program & shared governance
Public Service Loan Forgiveness (PSLF) eligible employer+ free student loan coaching and assistance navigating the PSLF program
National Health Service Corps (NHCS) and Colorado Health Service Corps (CHSC) eligible employer
Our Values
Respect
Belonging
Accountability
Transparency
All job applicants for safety-sensitive positions must pass a pre-employment drug test, once a conditional offer of employment has been made.
Denver Health is an integrated, high-quality academic health care system considered a model for the nation that includes a Level I Trauma Center, a 555-bed acute care medical center, Denver?s 911 emergency medical response system, 10 family health centers, 19 school-based health centers, Rocky Mountain Poison & Drug Safety, a Public Health Institute, an HMO and The Denver Health Foundation.
As Colorado?s primary, and essential, safety-net institution, Denver Health is a mission-driven organization that has provided billions in uncompensated care for the uninsured. Denver Health is viewed as an Anchor Institution for the community, focusing on hiring and purchasing locally as applicable, serving as a pillar for community needs, and caring for more than 185,000 individuals and 67,000 children a year.
Located near downtown Denver, Denver Health is just minutes away from many of the cultural and recreational activities Denver has to offer.
We strongly support diversity in the workforce and Denver Health is an equal opportunity employer (EOE).
Denver Health values the unique ideas, talents and contributions reflective of the needs of our community. For more about our commitment to diversity visit: https://www.denverhealth.org/for-professionals/careers/diversity-and-inclusion
Applicants will be considered until the position is filled.