Claims Review Representative II at CareerBuilder

Posted in Other 8 days ago.

Location: St. Louis, Missouri





Job Description:

It's more than a career, it's a calling.

MO-SSM Health St. Mary's Hospital - St. Louis



Worker Type:

Regular



Job Highlights:



Fantastic full time opportunity awaits. The ideal candidate will have experience with billing and coding, able to resolve account issues for reimbursement. Take your career to the next level with SSM Health



Job Summary:

Performs claims review by auditing patient bills, claims and revenue reports.



Job Responsibilities and Requirements:



PRIMARY RESPONSIBILITIES


  • Ensures compliance with all governmental, payer and SSMHC billing guidelines through review and correction of claims with potential compliance issues as identified by SSM billing systems.

  • Resolves inquiries and reconciles accounts.

  • Enhances net revenue by reviewing billing error or edits and correcting issues prior to submission to insure all entitled revenue is collected.

  • Identifies process improvement opportunities and participates in improvement plans.

  • Works on special projects as needed.

  • May review the work of others.

  • Performs other duties as assigned.



EDUCATION


  • High school diploma or equivalent



EXPERIENCE


  • One year experience



PHYSICAL REQUIREMENTS


  • Frequent lifting/carrying and pushing/pulling objects weighing 0-25 lbs.

  • Frequent sitting, standing, walking, reaching and repetitive foot/leg and hand/arm movements.

  • Frequent use of vision and depth perception for distances near (20 inches or less) and far (20 feet or more) and to identify and distinguish colors.

  • Frequent use of hearing and speech to share information through oral communication. Ability to hear alarms, malfunctioning machinery, etc.

  • Frequent keyboard use/data entry.

  • Occasional bending, stooping, kneeling, squatting, twisting and gripping.

  • Occasional lifting/carrying and pushing/pulling objects weighing 25-50 lbs.

  • Rare climbing.




Department:

87140033 STL/IL Finance Revenue Integrity



Work Shift:

Day Shift (United States of America)



Scheduled Weekly Hours:

40


SSM Health complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability or sex.


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