• Reviews payer EOB?s but not limited to payment accuracy, patient liability, and appeal grievances
• File appeals on underpayments
• Forward appeal letters to scanning
• Generate reports from the Managed Care module to identify issues but not limited to underpayments, total charge adjustments, missing calculations, and contract accuracy
• Generate reports from the Managed Care module to assist management identifying payer problem accounts
• Create a monthly Medicaid HMO underpayment report for the CFO
• Process incoming mail correspondence from payers within 3 business days.
• Follow up with the payer via phone and/or the website as needed

• Enter detailed notes explaining account activity in the Patient Accounts system including expected payment calculation

• Identify payer trends for resolution

• Report payer trends to the Director and/or Assistant Director of Patient Financial Services

• Assist the Reimbursement Specialist when needed
• Respond to patient inquiries within 2 business days
• Respond to interdepartmental inquiries within 2 business days
• Respond to payer requests within 2 business days
• Respond to emails within 2 business days

• Maintain courtesy and respect at all times when working with internal and external customers

Education

Required:

    High School

Licenses & Certifications

Preferred:

    C-Heartsaver

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About CHRISTUS Health

CHRISTUS HEALTH is an international Catholic, faith-based, not-for-profit health system comprised of almost more than 600 services and facilities, including more than 60 hospitals and long-term care facilities, 350 clinics and outpatient centers, and dozens of other health ministries and ventures. CHRISTUS operates in 6 U.S. states, Colombia, Chile and 6 states in Mexico. To support our health care ministry, CHRISTUS Health employs approximately 45,000 Associates and has more than 15,000 physicians on medical staffs who provide care and support for patients. CHRISTUS Health is listed among the top ten largest Catholic health systems in the United States.

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