Strength Through Diversity
Ground breaking science. Advancing medicine. Healing made personal.
Responsible for ensuring unpaid and partially paid claims are resolved in an efficient and timely manner. Resolves EOB discrepancies and researches refunds. Monitors and ensures that collections, net, gross and days in accounts receivable targets are met
Roles & Responsibilities:
- Follows up on submitted claims, monitors unpaid claims and resubmits claims with appropriate corrections and documentation
Works declines and processes appeals
Responds to patient and third party inquiries; researches and resolves simple to moderately complex issues; corrects errors and refers complex issues to supervisor
Reviews correspondence and rejection data from insurance carriers; posts rejections and performs reconciliations
May transfer secondary balances to appropriate financial class and provides documentation for processing the claims
Reviews Credit Letter Sent (CLS) and transfers balance to appropriate financial class and dunning level
Reviews, works and clears electronic and claims edits daily; summarizes and forwards non-workable edits to supervisor for resolution
May process refunds for supervisory approval
Prepares and submits referring physician updates and other major dictionary requests to supervisor for approval
Maintains strictest confidentiality; adheres to all HIPAA and Federal Payor guidelines/regulations
Performs other related duties
- Education: Associates Degree or HS Diploma/GED plus two years of related experience
Experience: 2 years healthcare billing experience required. Familiarity with CPT and ICD( coding and CCI edits
Electronic claims processing preferred.
Strength Through Diversity
The Mount Sinai Health System believes that diversity is a driver for excellence. We share a common devotion to delivering exceptional patient care. Yet we’re as diverse as the city we call home- culturally, ethically, in outlook and lifestyle. When you join us, you become a part of Mount Sinai’s unrivaled record of achievement, education and advancement as we revolutionize medicine together.
We work hard to acquire and retain the best people, and to create a welcoming, nurturing work environment where you can develop professionally. We share the belief that all employees, regardless of job title or expertise, can make an impact on quality patient care.
Explore more about this opportunity and how you can help us write a new chapter in our story!
Who We Are
Over 38,000 employees strong, the mission of the Mount Sinai Health System is to provide compassionate patient care with seamless coordination and to advance medicine through unrivaled education, research, and outreach in the many diverse communities we serve.
Formed in September 2013, The Mount Sinai Health System combines the excellence of the Icahn School of Medicine at Mount Sinai with seven premier hospital campuses, including Mount Sinai Beth Israel, Mount Sinai Beth Israel Brooklyn, The Mount Sinai Hospital, Mount Sinai Queens, Mount Sinai West (formerly Mount Sinai Roosevelt), Mount Sinai St. Luke’s, and New York Eye and Ear Infirmary of Mount Sinai.
The Mount Sinai Health System is an equal opportunity employer. We promote recognition and respect for individual and cultural differences, and we work to make our employees feel valued and appreciated, whatever their race, gender, background, or sexual orientation.