Job Description
How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives. Work Shift Day (United States of America) Job Summary Under the direction of the Manager of Account Resolution, the Account Resolution Representative II assists with planning and coordinating HB Accounts Resolution follow up activities for an account receivable portfolio of ~ approximately $375M-$500M, including, but not limited to collaboratively working with their Team Lead, Manager, and assisting with training, employees, as circumstances dictate. The Account Resolution Representative II will assist with the development of strategies for establishing a continuous improvement work environment, ensure eligible accounts are reviewed, appealed, escalated or adjusted within the designated payer time frames and are documented appropriately in the patient accounting system. As well as providing educational support in a variety of departmental and individual settings. The role requires data analysis, trending analysis, and educational capabilities regarding payor and revenue cycle business related processes. This role requires a versatile and well developed actionable understanding with demonstrated knowledge of billing, collections, denial management, contractual provision interpretation and provider / payor appeal requirements. In addition to a strong understanding and capability of common business technologies such as MS Office, Excel, PowerPoint, Word and Outlook to perform and communicate the assessment and analysis of multiple acute care and LTAC facility accounts receivable trending and findings is needed. The core role focus of this position is to ensure that accounts are brought final resolution through reimbursement for services and to mitigate financial losses through solid operational execution, development and conformity to defined Policies and Procedures. The Account Resolution Representative II must possess the ability to assist with developing and documenting action plans for quick resource deployment, communicate timely with leadership to understand the specific reasons for payment delays. The role requires the ability to effectively and efficiently communicate both orally and in writing to leadership, multi-task, meet deadlines, adhere to organizational policies and procedures. In addition, the Account Resolution Representative II will assist with additional Revenue Cycle related tasks and duties as assigned. Core Responsibilities And Essential Functions Maintain a working knowledge and perform assigned duties in compliance of all-departmental billing and follow-up policies, procedures, processes and functions. Respond appropriately to inquiries from 3rd parties, insurance providers and patients regarding accounts, collection issues and hospital policies, to insure a minimal Accounts Receivables inventory. Collect and resolve payments from insurance companies by working with assigned payers and utilizing established policies and procedures. Research and resolve payer rejected/denied claims and analyze accounts for insurance payment accuracy/completeness and for payer claim processing accuracy per contract. Successfully appeal denied accounts and avoid excessive deferred accounts Demonstrate effective collaboration skills, and support to the follow-Up staff in the performance of their daily functions by assisting with daily planning, organizing, prioritizing and management of workflow, as instructed by leadership. Review account receivables while evaluating trends and tracking recovery efforts by utilizing various departmental tools optimizing individual workflow and process to reduce AR growth, quickly propose solutions to reduce trends, resolve issues, etc. Consistently meet the productivity and quality standards. Assist staff by providing direction and guidance, creating a team environment through training, recognition, and education which produces optimum work habits and job performance Assist with setting obtainable short-term goals, maintaining expected level of productivity and quality as defined by policy, or equivalent industry standards when not specifically defined by policy, as well as assisting with performance studies to improve productivity, streamline operations and reduce error rates. Provide assistance with staff training and oversight to ensure that implemented policies and procedures are being followed. Meet deadlines established through interaction with the Manager of Accounts Resol