We are more than a health system. We are a belief system. We believe wellness and sickness are both part of a lifelong partnership, and that everyone could use an expert guide. We work hard, care deeply and reach further to help people uncover their own power to be healthy. We inspire hope. We learn, grow, and achieve more – in our careers and in our communities.
This position is for a Revenue Integrity Payment Variance Specialist. The person for this position would need to have a strong background in how insurance companies work, how the contracts are designed, written and maintained and have a very keen eye for spotting payment variances amongst all of our contracted insurance companies
30%
Maintains accounts receivable balance and follows up on collection of accounts: -Reconciles cash receipts/cash posting-Updates appropriate records as payments are received. -Maintains accounts receivable, does follow-up with payors on regular and on-going basis. -Balance bills secondary insurance and patients/families. -Works with medical records to ensure complete/accurate charts for billing compliance. -Reports denials and billing problems to Account Receivable Supervisor. -Prepares recertification reports.
30%
Verifies insurance information to ensure accurate and timely billing of all patient revenue, negotiation of per diem payment with commercial payors and timely billing of all patient revenue: -Assists patients/families and staff in completion of all paperwork to obtain eligibility. -Verifies primary and secondary payors for each patient from admission paperwork. -Verifies coverage for all commercial insurance prior to admission, negotiating payment with assistance from Accounts Receivable Supervisor as appropriate. -Documents all pertinent information in the patient billing file and maintains file. -Works with patients/families to advise of potential financial responsibility. -Notifies payors of patient elections and discharges as appropriate.
20%
Coordination of third party and patient billing: -Prepares billing forms and required documentation and completes billing of all services to the appropriate payors.
10%
May assume job duties of the AR Supervisor and/or co-worker's in their absence. Responsible for training new staff and cross training of other staff on responsibilities.
10%
Performs other miscellaneous duties which includes, but is not limited to: Collecting data and preparing reports, maintaining all paper and computer files relative to the area, participate in staff meetings, support activities, and in-services and retreats to nurture personal and professional growth.
As a High Reliability Organization (HRO), responsibilities require focus on safety, quality and efficiency in performing job duties.
The job profile provides an overview of responsibilities and duties and is not intended to be an exhaustive list and is subject to change at any time
High School or GED (Required)
Must have a good understanding of medical coding and working knowledge of medical terminology. Must be able to work as part of team with attention to detail and balanced concern for both accuracy and efficiency.
Day
40
Corporate Revenue Integrity
Join us!
... if your passion is to work in a caring environment
... if you believe that learning is a life-long process
... if you strive for excellence and want to be among the best in the healthcare industry
OhioHealth is an equal opportunity employer and fully supports and maintains compliance with all state, federal, and local regulations. OhioHealth does not discriminate against associates or applicants because of race, color, genetic information, religion, sex, sexual orientation, gender identity or expression, age, ancestry, national origin, veteran status, military status, pregnancy, disability, marital status, familial status, or other characteristics protected by law. Equal employment is extended to all person in all aspects of the associate-employer relationship including recruitment, hiring, training, promotion, transfer, compensation, discipline, reduction in staff, termination, assignment of benefits, and any other term or condition of employment
Positions marked as remote are only eligible for work from Ohio.
OhioHealth is a nationally recognized, not-for-profit, faith-based health system of more than 35,000 associates, providers and volunteers. We lead with our mission to improve the health of those we serve throughout our 16 hospitals and 200+ urgent, primary and specialty care sites spanning 50 Ohio counties.
Headquartered in Columbus, Ohio, we’re proud to be consistently recognized by FORTUNE as one of the “100 Best Companies to Work For” and rated a Top Hospital & Health System by Fair360 in 2024.
