JobMesh

Business Office Representative, Admin/Business Support - (Full time Days)

Rochester Regional Health · Rochester, New York, US

Summary: Ensure full reimbursement is received by RRH for clinical services rendered including professional, long-term/home care and hospital care, by effect...

Job description

Summary: Ensure full reimbursement is received by RRH for clinical services rendered including professional, long-term/home care and hospital care, by effectively and accurately managing a receivable. Resolve edits to ensure accurate claims are sent to primary and secondary insurances. Research and resolve denials and payer requests for information promptly and accurately in order to secure payment. Work as part of a dynamic team continually looking for ways to improve a complex business process. JOB TITLE: Business Office Representative, Admin/Business Support- (Full time, Days) DEPARTMENT: Admin/Business Support: LOCATION: Riedman Campus- 100 Kings Highway South Rochester NY 14617 HOURS PER WEEK: 40: SCHEDULE: 8- 4:30pm: Key Responsibilities: - Review and accurately process claim edits in a system work queue. Accurately handle claim adjustments and coverage changes as needed. - Review and process claim denials according to established processes. Research and resolve denial issues via the payer website, coverage policies and/or phone calls to the payer. Submit corrected claims and appeals. - Process account adjustments and refunds as needed according to department policy and proce...