ABOUT SHERIDAN MEMORIAL HOSPITAL
Sheridan Memorial Hospital is a progressive, state-of-the-art facility nestled beneath the Big Horn Mountains in beautiful Northeast Wyoming. Founded over 100 years ago, Sheridan Memorial is licensed for 88 beds with over 60 physicians who provide primary medical care and specialty care in more than 15 areas. We are proud of our more than 600 employees who provide personalized, patient centered care in a healing environment. When people think of excellent healthcare, they think of Sheridan.JOB SUMMARY
Responsible for compiling itemized hospital bills, verifying patient insurance coverage and computing patient insurance benefits. Works closely with the Admitting Office, Medical Records and insurance companies. Participates in Performance Improvement activities.ESSENTIAL DUTIES/RESPONISIBILITIES
- Verifies accurate encounter information by working Edit Failure Working in Cerner, making necessary corrections to insure timely claim submission.
- Monitors all claims in Emdeon correcting edits as need to insure claim submission and reimbursement.
- Contacts patients when additional information is required to file an insurance claim or when the insurance company has requested additional information from the member
- Stays informed about changes in Medicare and Medicaid, Blue Cross/Blue Shield and other third party payors.
- Processes correspondence and Explanation of Benefits in a timely manner.
- Processes overpayment refunds as required.
- Timely in making contact with insurance companies on claims that have exceeded the time expectation for payment.
- Remains current on Worker’s Compensation and other third party payors for billing functions.
- Stays current on assigned patient encounter “workQ in Cerner RevenueCycle.
- Demonstrates the ability to be flexible, organized and function well in stressful situations.
- Interacts with patients/families in a professional manner. Provides explanations regarding statements, insurance coverage.
- Treats patients/families with respect; ensures confidentiality of patient records.
- Maintains a good working relationship within the department and with other departments.
- Maintains a professional working relationship with insurance companies.
- Performs other duties as assigned.
- Ensures documentation meets standards and policies.
Disclaimer: The above description has been designed to indicate the general nature of work performed within this position.
Education/Experience/Licenses and Certifications
- High school diploma or general equivalency diploma (GED), required.
- Medical terminology preferred but not required.
- Billing or accounting preferred but not required.
- Ability to effectively communicate in English, both reading and writing.
- Multi-line telephone knowledge.
- Computer knowledge.
- Ability to operate designated equipment as specified including computer keyboarding.
- Basic clerical training, including basic filing procedures (both numerically and alphabetically).
- Ability to work under pressure with time constraints.
- Basic knowledge of medical record content and sequence.
- Ability to function independently with minimal direction.
Sheridan Memorial Hospital is an equal opportunity/Affirmative Action employer and gives consideration for employment to qualified applicants without regard to age, race, color, religion, sex, national origin, disability or protected veteran status. If you’d like more information about your EEO rights as an applicant under the law, please click here
Specific demands not listed: Possible exposure to blood and or body fluids / infectious disease / hazardous waste requiring the use of Personal Protective Equipment. Exposure to odorous chemicals / specimens and Latex products.
Pre-employment drug and alcohol screening is required.