Back to Home Page
Communities Industries Employers JobSeekers Advertisers PJScout Resources Recruiters About
Keywords (e.g. nurse, sales) Category State City Radius
 
Claims Analyst Home+
Regional Health
Regional Health
 

Job Location: Rapid City, SD
Job Type: Full time
Hours: Scheduled Weekly Hours40
Department: Home Plus ST HME
Scheduled Weekly Hours:
40
Shift:
Day (United States of America)

Employee TypeRegular

Job Summary:

Performs those duties necessary to ensure the proper interpretation, processing, recording, approval and payment of inpatient and outpatient medical claims. Accurately reviews information for processing claims into a computerized system in accordance with the primary payer specifications and billing guidelines.

Job Description:

Essential Functions:

  • Conducts timely follow up of claims as needed.
  • Demonstrates application of compliance standards and payer specific data to properly file claims, ensures prompt, appropriate reimbursement of services and supplies billed to third parties and appropriate payment of services and supplies due from patients, as evidenced by documentation, observation and feedback.
  • Demonstrates a working knowledge of third party payor procedures including, but not limited to; Medicare, Medicaid, Champus, Blue Cross and all other third party contractual agreements entered into.
  • Uses tools provided to track and trend patterns of claim submission issues that might require Compliance and Charge master staff to resolve, or HIPAA transaction code set review. Research payor requirements and offer suggestions to leadership for claims submission issues.
  • Maintains and updates appropriate system documentation to provide information regarding claim processing to internal or external customers.
  • Identifies unresolved requests of patient responsibility and transfers account to self pay. Performs duties and provides best customer service using behaviors that demonstrate responsibility and accountability.
  • Participates in departmental activities related to performance improvement and quality control.
  • All other duties as assigned.

    Additional Requirements:

    Preferred:
    Experience - 1+ years of Clerical Experience; 1+ years of Medical Patient Accounts/Financial Services Experience
    Education - Bachelors degree in Accounting, Business, Health Related Field
    Certifications - Certified Clinical Account Technician (CCAT) - Accredited University or accredited training professionals; Certified Patient Account Technician (CPAT) - Accredited University or accredited training professionalsPhysical Requirements:
    Sedentary work - Exerting up to 10 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects, including the human body. Sedentary work involves sitting most of the time.Make a difference. Every day.Regional Health is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or protected Veteran status.








    • Apply






        Posted 5 Days Ago








          Full time








            R7315








          About Us














            • Regional Health is an integrated health care system with the purpose of helping patients and communities live well. The organization, with headquarters in Rapid City, S.D., provides community-based health care in more than 20 communities in two states and 32 specialty areas of medicine. As the largest private employer in western South Dakota, Regional Health is comprised of five hospitals, 24 clinic locations and employs nearly 5,000 physicians and caregivers. Regional Health is committed to the future of medicine, with medical training partnerships, a medical residency program, and more than 130 active research studies.








            Similar Jobs




























            Follow Us












            2019 Workday, Inc. All rights reserved.










            Employee Benefits:
            Regional Health offers a highly competitive and comprehensive benefits package that looks out for you and your family. We recognize there are many types of families, with many different needs. That's why our plans are flexible, allowing you to select the individual benefits which fit your personal needs.

            Regional Health is an integrated health care system with the purpose of helping patients and communities live well. The organization, with headquarters in Rapid City, S.D., provides community-based health care in more than 20 communities in two states and 32 specialty areas of medicine. As the largest private employer in western South Dakota, Regional Health is comprised of five hospitals, 24 clinic locations and employs nearly 5,000 physicians and caregivers. Regional Health is committed to the future of medicine, with medical training partnerships, a medical residency program, and more than 130 active research studies.

            How to Apply:





            Regional Health

            Come join us in our pursuit to become the best healthcare system in America!
            Regional Health is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or protected Veteran status.

             
            See all jobs in Rapid City SD
              Share this job
            Share |

            PJ Scout
            Create Free Account

            PJ Scout
             
                INDUSTRIES | COMMUNITIES | EMPLOYERS | JOB SEEKERS | CUSTOMER LOGIN
                CONTACT US | ABOUT NATIONJOB | ADVERTISERS | PRIVACY
                Electronic Recruitment since 1988. Copyright 1995-2019 NationJob, Inc. All rights reserved.
            JobboardFinder - Search the best job board worldwide