Location:Geisinger South Wilkes-Barre (GSWB)
Shift:Days (United States of America)
Scheduled Weekly Hours:40
Worker Type:Regular
Exemption Status:No
Job Summary:Responsible for preparing and submitting third party claims for reimbursement, posting third party cash receipts, accounts receivable follow-up, collection activities, and additional duties in support of programs.
Job Duties:- Performs data entry into automated occupational medicine software system.
- Prepares monthly invoices detailing services performed for third parties, posting of cash receipts, and preparation of other reports and statements as necessary.
- Prepares, reviews, and submits certain claims for reimbursement.
- Obtains required forms and prepares correspondence for each third party file.
- Investigates discrepancies between authorizations issued and claims submitted, and submits claim forms with appropriate corresponding documentation to third parties.
- Requests and documents third party pre-authorizations.
- Provides patient financial counseling prior to the test, as appropriate.
- Reviews and investigates rejected or denied claims.
- Researches, corrects, and resubmits claims for payment.
- Identifies delinquent accounts.
- Performs follow-up with third parties and employers regarding payment by placing telephone calls, preparing correspondence, or resubmitting claims when necessary.
- Maintains confidentiality of patient information.
- Assists in the creation, generation, and distribution of informative reports to meet financial reporting needs.
- Alerts of unusual developments of critical situations concerning billing, accounts receivable, or collection issues.
Work is typically performed in an office environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job. *Relevant experience may be a combination of related work experience and degree obtained (Associate's Degree = 2 years; Bachelor's Degree = 4 years).
Position Details:Geisinger cares about not only its patients and members but also about you and your family. We offer a competitive compensation and benefits package to ensure that you and your loved ones can maintain good health, achieve financial stability, and excel both personally and professionally. We believe in creating a diverse and inclusive environment where all employees can be their authentic selves. To learn more:
Benefits of working at Geisinger:- Full benefits (health, dental and vision) starting on day one
- Three medical plan choices, including an expanded network for out-of-area employees and dependents
- Pre-tax savings plans with healthcare and dependent care flexible spending accounts (FSA) and a health savings account (HSA)
- Company-paid life insurance, short-term disability, and long-term disability coverage
- 401(k) plan that includes automatic Geisinger contributions
- Generous paid time off (PTO) plan that allows you to accrue time quickly
- Up to $5,000 in tuition reimbursement per calendar year
- MyHealth Rewards wellness program to improve your health while earning a financial incentive
- Family-friendly support including adoption and fertility assistance, parental leave pay, military leave pay and a free Care.com membership with discounted backup care for your loved ones
- Employee Assistance Program (EAP): Referrals for childcare, eldercare, & pet care. Access free legal guidance, mental health visits, work-life support, digital self-help tools and more.
- Voluntary benefits including accident, critical illness, hospital indemnity insurance, identity theft protection, universal life and pet and legal insurance.
Education:High School Diploma or Equivalent (GED)- (Required)
Experience:Minimum of 4 years-Relevant experience* (Required)
Certification(s) and License(s):Skills:Communication, Computer Literacy, Teamwork
OUR PURPOSE & VALUES: Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities.
- KINDNESS: We strive to treat everyone as we would hope to be treated ourselves.
- EXCELLENCE: We treasure colleagues who humbly strive for excellence.
- LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow.
- INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation.
- SAFETY: We provide a safe environment for our patients and members and the Geisinger family.
We offer healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners. Perhaps just as important, we encourage an atmosphere of collaboration, cooperation and collegiality.We know that a diverse workforce with unique experiences and backgrounds makes our team stronger. Our patients, members and community come from a wide variety of backgrounds, and it takes a diverse workforce to make better health easier for all. We are proud to be an affirmative action, equal opportunity employer and all qualified applicants will receive consideration for employment regardless to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or status as a protected veteran.