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1. Title: Sr Acct Reimbursement Spec
2. Job Code: 6211
3. Job Stream Description: Support/Technical
4. Title: Sr Acct Reimbursement Spec
5. Job Code: 6211
6. Job Stream Description: Support/Technical

• Processes claims, payments, adjustments, refunds, denials, and unpaid patient and insurance balances.
• Accesses and corrects, if needed, demographic, insurance and financial information.
• Provides accurate account maintenance and documentation.
• Serves as a liaison with insurance companies, third party payors, and administrative personnel.
• Analyzes incoming financial data to identify, reconcile, and resolve patterns resulting in erroneous or no reimbursement.
• The responsibilities listed are a general overview of the position and additional duties may be assigned.

TECHNICAL CAPABILITIES:

CODING KNOWLEDGE (NOVICE): - Ability to assign and interpret ICD-10-CM/PCS coding classification systems and MS-DRG and APR-DRG prospective payment and severity systems.

DATA ENTRY (INTERMEDIATE): - The ability to transcribe information from the original source into an electronic system according to written and verbal instructions efficiently and accurately.

REVENUE CYCLE (NOVICE): - Knowledge of the financial process to track patient care from registration and scheduling to the final payment of a balance.

• Organizational Impact: Performs non-routine tasks that significantly impact team's performance with minimal guidance.
• Problem Solving/ Complexity of work: Conducts research and analysis to solve some non-routine problems.
• Breadth of Knowledge: Applies broad job knowledge and has basic job skills in other areas.
• Team Interaction: Provides informal guidance and support to less experienced team members.

CORE CAPABILITIES:

SUPPORTING COLLEAGUES (S3):

• - Develops Self and Others: Continuously improves own skills by identifying development opportunities.
• - Builds and Maintains Relationships : Seeks to understand colleagues' priorities, working styles and develops relationships across areas.
• - Communicates Effectively: Openly shares information with others and communicates in a clear and courteous manner.

DELIVERING EXCELLENT SERVICES (S3):

• - Serves Others with Compassion: Invests time to understand the problems, needs of others and how to provide excellent service.
• - Solves Complex Problems: Seeks to understand issues, solves routine problems, and raises proper concerns to supervisors in a timely manner.
• - Offers Meaningful Advice and Support: Listens carefully to understand the issues and provides accurate information and support.

ENSURING HIGH QUALITY (S3):

• - Performs Excellent Work: Checks work quality before delivery and asks relevant questions to meet quality standards .
• - Ensures Continuous Improvement: Shows eagerness to learn new knowledge, technologies, tools or systems and displays willingness to go above and beyond.
• - Fulfills Safety and Regulatory Requirements: Demonstrates basic knowledge of conditions that affect safety and reports unsafe conditions to the appropriate person or department.

MANAGING RESOURCES EFFECTIVELY (S3):

• - Demonstrates Accountability: Takes responsibility for completing assigned activities and thinks beyond standard approaches to provide high-quality work/service.
• - Stewards Organizational Resources: Displays understanding of how personal actions will impact departmental resources.
• - Makes Data Driven Decisions: Uses accurate information and good decision making to consistently achieve results on time and without error.

FOSTERING INNOVATION (S3):

• - Generates New Ideas: Willingly proposes/accepts ideas or initiatives that will impact day-to-day operations by offering suggestions to enhance them.
• - Applies Technology: Absorbs new technology quickly; understands when to utilize the appropriate tools and procedures to ensure proper course of action.
• - Adapts to Change: Embraces change by keeping an open mind to changing plans and incorporates change instructions into own area of work.