Remote Utilization Review RN Case Manager - Care Management
Trinity Health is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians across 25 states.$58k-92k yearly est.6d ago
Sr. Patient Accounts Representative
It's more than a career, it's a calling.
MO-SSM Health Wool Center
Worker Type:
Regular
Job Highlights:
SIGN ON BONUS ELIGIBLE - UP TO $1,000!
Exciting opportunity for a Senior Patient Accounts Representative within SLUCare Physician Group! SLUCare has a wide variety of specialty areas, with over 17 departments, 50+ subspecialties, and 600+ physicians and providers.
Schedule:
Monday-Friday, no nights, no weekends. Clinics closed on holidays.
Hours:
8am-5pm in an outpatient clinic environment with SLUCare Physician Group.
Remote work may be available for this role. Full-Time, benefits eligible opportunity.
**
Sign on bonuses are for external qualified candidates
.
Internal candidates, please check with your recruiter to see what options are available for you. Must be 18 years or older to qualify for sign on bonus.**
Job Summary:
Responsible for processing patient accounts. Duties may include one or more of the following: processing insurance payments, following up on denied claims, and resolving credit balances. May work in multiple functional areas.
Job Responsibilities and Requirements:
PRIMARY RESPONSIBILITIES
Processes the insurance component of a patient's obligation using the third party claims processing and payment rules. Bills claims appropriately.
Follows up on denied claims by performing appeals and denial recovery procedures. Works denied claim lines and no response claims to resolve outstanding accounts.
Analyzes credit balances on patient accounts and resolves. Responds to refund request letters from insurance carriers.
Identifies process improvement opportunities and participates in improvement plans.
Works on special projects as needed.
May review the work of others.
Performs other duties as assigned.
EDUCATION
High school diploma or equivalent
EXPERIENCE
One year experience
PHYSICAL REQUIREMENTS
Frequent lifting/carrying and pushing/pulling objects weighing 0-25 lbs.
Frequent sitting, standing, walking, reaching and repetitive foot/leg and hand/arm movements.
Frequent use of vision and depth perception for distances near (20 inches or less) and far (20 feet or more) and to identify and distinguish colors.
Frequent use of hearing and speech to share information through oral communication. Ability to hear alarms, malfunctioning machinery, etc.
Frequent keyboard use/data entry.
Occasional bending, stooping, kneeling, squatting, twisting and gripping.
Occasional lifting/carrying and pushing/pulling objects weighing 25-50 lbs.
Rare climbing.
Department:
9991540235 Z460 PMO-Accounts Receivable
Work Shift:
Day Shift (United States of America)
Scheduled Weekly Hours:
40
SSM Health is an equal opportunity employer. SSM Health does not discriminate on the basis of race, color, religion, national origin, age, disability, sex, sexual orientation, gender identity, pregnancy, veteran status
,
or any other characteristic protected by applicable law. Click here to learn more.
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Trinity Health may also be known as or be related to TRINITY HEALTH - MICHIGAN, Trinity Health, Trinity Health (hq Michigan) and Trinity Health Corporation.