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Provides the necessary functions to bill, collect, analyze, and adjudicate all professional and/or hospital billing and collection functions. Executes and performs programs to insure efficient operations of program in order to generate sufficient cash flow to support operations and strategic initiatives. Responsibilities include billing and collecting for all third-party insurance payers, adjustment functions, cash application, adjudicating, identifying, analyzing, reducing and resolving various revenue enhancement, and credit balance issues associated with professional and/or hospital accounts receivable and insuring monthly cash flow. These responsibilities further include the management of a portfolio of accounts with respect to the successful adjudication of claims on a monthly basis.
Performs professional and/or hospital billing and collection functions within the revenue management to include, but not limited to billing and collection functions, secondary collections, cash posting, A/R resolution, adjustments, credit balance resolution, revenue enhancement and cash flow for the various clinical service lines.
Performs the above-mentioned activities of the revenue management to insure cost effectiveness and organizational efficiency.
Furthermore, this position executes these functions in regard to how their function inter-relates to the other revenue management functions and all of the various third-party payers associated with the clinical service lines.
Communicates their functional activities to their leader, senior management as it relates to billing, insurance follow-up, cash flow, cash application, revenue enhancement, organizational profitability, customer service, accounts receivable results and revenue management results.
Works in conjunction with other areas to insure coordinated activities with respect to all revenue management needs.
Participates in a minimum of sixty hours of classroom training per year.
Involved, when required, in the development of various strategic plans.
Develops, implements and directs various quality initiatives to insure continuous monitoring and improvements within the revenue management process.
This includes performing overall departmental operating functions within pre-determined limits, ensuring operational efficiencies and obtaining pre-determined performance and quality targets.
Provides analysis to supervisor and manager of trends and issues identified.
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.
High School Diploma or Equivalent (GED)- (Required), Associate's Degree- (Preferred)
Minimum of 3 years-Related work 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.