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Provides the necessary functions to bill, collect, analyze, and adjudicate all hospital and professional accounts and functions. This position executes and performs programs to insure efficient operations in order to resolve credit balances to support operations and strategic initiatives. In the position of Credit Balance Specialist II, responsibilities include resolving credits for all patients and third party insurance payers, cash application, adjudicating, identifying, analyzing and associated with hospital and professional accounts.
Performs all hospital and professional credit balance for various payers and cash application functions within the revenue management to include, but not limited to hospital and professional billing, charge corrections, cash application, credit balance resolution, revenue enhancement and cash flow for various service lines.
Performs the above-mentioned activities of the revenue management to insure cost effectiveness and organizational efficiency.
Furthermore, this position executes these functions within the service line structure and in regards to how their function inter-relates to the other revenue management functions and all of the various third party payers associated with the service lines..
Understands and strives to meet Revenue Management targets, decrease overall AR over 90 days, increase cash and effectively works through and assists patients and providers with the Discounting Policies and Bad Debt Policies.
Advises management of any unusual development or operational problems within area of responsibility and make recommendations for process improvement within the department.
Gains and maintains a working knowledge of a minimum of two payers and CBT staff's duties to be able to offer assistance to other co-workers as necessary.
Provides training for new or established staff as assigned.
Conducts research and follow-up activities on assigned accounts according to established procedures and time frames.
Assists in maintaining control over aged accounts Responsible for maintaining a working knowledge of Revenue Management related software.
Develops, implements, and directs various quality initiatives to insure continuous monitoring and improvements within the revenue management process of Geisinger.
This includes performing overall departmental operating functions within pre-determined limits and within Freedom-To-Act guidelines to insure operational efficiencies and obtaining pre-determined performance targets.
Facilitates of various technological initiatives in support of business process improvements with respect to all revenue management functions and various service lines.
Works in conjunction with other areas within the revenue management and Geisinger to insure coordinated activities with respect to revenue management credit balance AR and team needs.
Work is typically performed in an office environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job. *Relevant experience may be a combination of related work experience and degree obtained (Associate's Degree = 2 years; Bachelor's Degree = 4 years).
If a suitably experienced candidate cannot be found, applicants who meet the basic qualifications but possess fewer years of experience will be considered for hire at a lower level. Salary would commensurate with experience.
High School Diploma or Equivalent (GED)- (Required)
Minimum of 4 years-Relevant experience* (Required)
We are an Affirmative Action, Equal Opportunity Employer Women and Minorities are Encouraged to Apply. All qualified applicants will receive consideration for employment and will not be discriminated against on the basis of disability or their protected veteran status.
At Geisinger, our innovative ideas are inspired by the communities we serve – like our Fresh Food
Farmacy, a program that delivers life-saving healthy alternatives to patients with diabetes. With additional tools like our MyCode Community Health Initiative, one of the first health system genome sequencing
programs, and our new asthma app suite that we developed in partnership with AstraZeneca, it’s no wonder we’re ranked one of the Top 5 Most Innovative Healthcare Systems by Becker's Hospital Review. We continually work towards continuous improvement in a culture where everyone has a voice and firmly believe that better begins with all of us.
Founded more than 100 years ago, Geisinger serves more than three million residents throughout central, south-central and northeastern Pennsylvania and southern New Jersey. Our physician-led system is comprised of 30,000 employees, including 1,600 employed physicians, and consists of 13 hospital campuses, the Geisinger Health Plan, Geisinger Commonwealth School of Medicine and two research centers.
What you do at Geisinger shapes the future of health and improves lives – for our patients, communities, and you.