at Sedgwick County in Wichita, Kansas, United States
Job Description
Responsible for tasks related to revenue collection of COMCARE services billed to various payor sources to ensure we are maximizing revenues. Duties include insurance updates, processing recoupment requests with various payors and follow-up on accounts receivables.
Regular, reliable, and non-disruptive attendance is an essential job duty, as is the ability to create and maintain collegial, harmonious working relationships with others. Employee must be able to complete complex tasks by applying CCBHC practices, standard office policies, authorized instructions, and past precedents to achieve a desired outcome. Employee must quickly recognize emergency or sensitive situations and take appropriate action. Critical decision making and the ability to think through the consequences of a decision are essential in this position.
Process payor recoupments
- Contact payors regarding compliance recoupments
- Submit recoupment requests for various payors
- Follow up on recoupments to ensure processing is done timely
- Update /Correct billing transaction on patient account
Processing Accounts Receivable transactions
- Monitor status of aged accounts with various payors
- Research outstanding claims and make any corrections necessary so that claims can be processed correctly
- Verify accuracy of denial and payment discrepancies
- Communicate with payor customer service representatives to resolve claim issues
- Assist working electronic claim errors and rejections; making corrections and resubmitting claims as needed
- Process insurance request for information
- Work monthly Patient Balance reports
- Assist with auditing accounts for accuracy prior to submission to Kansas Setoff
- Post payments for assigned payers.
- Work monthly eligibility reports
Manage Waiver client accounts
- Process SED (Severely and Emotionally Disturbed) Waiver eligibility forms (3160/3161) as received
- Verify coverage accuracy and retrobill applicable dates of service to updated payor
- Communicate with program staff regarding any insurance coverage issues
- When notified of client Waiver authorization status, verify all dates of service are covered and ensure transactions are processed correctly
- Verify Waiver authorizations and retrobill affected charges
- Prepare and submit monthly waiver assessment invoices; enter assessment services and guarantor information into electronic medical record
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