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Full/Part Time: Full Time
Location/Affiliates: The Mount Sinai Hospital
Department: 513 - PFS Self Pay/Financial Intake
Requisition Number: 14-1615814
The Financial Specialist is responsible for billing and collection activities, which include verification of insurance, pre-certifications, deposits and reconciliation of co-pays and self-pays, updating financial information in appropriate software applications and providing information on billing matters.
Duties and Responsibilities:
1. 1. Ensures claim edits and accounts receivables are resolved in an efficient and timely manner.
2. 2. Monitors claims for payment by insurance companies, co-payments and self pays.
3. 3. Resubmits claims for payment with appropriate updates and documentation as needed.
4. 4. Responds to patient and third party inquiries; researches and resolves problems; corrects errors and refers most complex issues to supervisor.
5. 5. Reviews correspondence and rejection data from insurance carriers; posts rejections and balances in appropriate financial classification.
6. 6. Transfers secondary balances to appropriate financial class and provides documentation for processing the claims.
7. 7. Reviews Credit Letter Sent (CLS) and transfers balance to appropriate financial class and dunning level.
8. 8. Prepares and submits referring physician updates and other major dictionary or master file request to supervisor for approval.
9. 9. Assists Billing Manager with the training of new hires.
10. 10. Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations.
11. 11. Performs other related duties
High School graduate or equivalent. Advanced medical billing and computerized billing system training.
Excellent organizational skills
Excellent communication and customer service skills
Knowledge of medical terminology and anatomy
Strong attention to detail
3 years healthcare billing experience working with CPT and ICD( coding and CCI edits.
Electronic claims processing preferred.
Mount Sinai Medical Center is an equal opportunity/affirmative action employer. We recognize the power and importance of a diverse employee population and strongly encourage applicants with various experiences and backgrounds. Mount Sinai Medical Center--An EEO/AA-D/V Employer.