Self-Pay Integrity Analyst (REMOTE)

Responsible for ensuring Self-Pay accounts as worked correctly, make sure letters are not stalled in the system and patient letters are sent to patients within the guideline. Make sure accounts on a hold status are reviewed timely, which includes calling insurance companies for current claim status, review of self-pay accounts to ensure the patient balance is correct and all contractual adjustments and other discount have been applied.

Candidate MUST live in one of the following states;
Alabama, Alaska, Arizona, Arkansas, Colorado, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Mexico, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, West Virginia, Wisconsin, Wyoming

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Reviews assigned patient accounts to ensure that the accounts are in the correct financial class as well as ensure that the patient balance is correct and all payments, contractual adjustments and other discounts have been applied to the patient accounts correctly.
• Resolves any patient accounts that are on hold in a timely manner to ensure there isn’t a delay with patient billing. Ensure all assignments are worked by month end. The candidate must be able to work each month end.
• Assesses self-pay COVID accounts to determine if the accounts would qualify to be billed
  to HRSA.
• Resolves any accounts that are in a hold status promptly. Ensure all adjustments and other discount are posted to the account by month end.
• Ensures accurate and complete account review of self-pay accounts before a statement is sent to the patient, work and collect on liability accounts that doesn’t met the PAIS Lien Unit threshold.
• Contacts insurance payors via telephone on aged/delayed claims for resolution; Contact patients/insurance companies on unresolved claims. Communicates with all parties in a professional manner and provides explanations regarding the account.

QUALIFICATIONS

REQUIRED EDUCATION AND EXPERIENCE

• High school diploma or equivalent
• A minimum of one (1) year experience with hospital or medical office collections.
• A minimum of one (1) year experience with carrier-specific reimbursement required as applicable to claim processing to include - benefits and coverage according to specific carrier; UB 04 claims form preparation; and 1500 claims form preparation.

KNOWLEDGE, SKILLS, AND ABILITIES

• Knowledge of the hospital revenue cycle and also Self-Pay AR.
• Intermediate knowledge or Microsoft Office Tools or Google Platform tools.
• Knowledge of hospital or business office collection systems and business software is required; Experience with Artiva and HMS systems preferred.

PHYSICAL DEMANDS
In order to successfully perform this job, with or without a reasonable accommodation, the following
are outlined below:

• The Employee is required to read, review, prepare and analyze written data and figures, using a PC
  or similar, and should possess visual acuity.
• The Employee may be required to occasionally climb, push, stand, walk, reach, grasp, kneel, stoop,
  and/or perform repetitive motions.
• The Employee is not substantially exposed to adverse environmental conditions and; therefore, job
  functions are typically performed under conditions such as those found within general office or
  administrative work.