Primary Duties and Responsibilities:

• Responsible for tracking, reporting and trending chart and edit volume to ensure timely processing and workflow integrity
• Evaluate and ensure proper chart flow ensuring deadlines are met
• Monitor departmental inventory by process and report to management daily
• Communicate and follow up on volume not processed as deadlines approach
• Research complex edits escalated to the department and implementing resolutions that result in denial prevention and an increase in billing quality and revenue
• Outbound calls to insurance carriers for additional data gathering
• Examine KAV reports on a monthly basis
  • Determine top denials
  • Initiate resolution
  • Report out for MOR

• Follow up and resolution to complex edit issues
• Frequent communication with offshore partners regarding deadlines and edit resolution
• Assist in meeting deadlines and target inventories by processing edits when needed
• Maintain a comprehensive knowledge of the departmental policies and procedures

Knowledge, Skills, and Abilities:

• Detail oriented and organized
• Self-motivated; capable of compiling/tracking data to meet deadlines and goals
• Excellent interpersonal skills
• Ability to work equally well individually and in a team environment and adhere to our CORE values of Agility, Courage, Collaboration and Respect
• Professional attitude and demeanor
• Written and oral communication skills
• Proficient computer knowledge of Word, Excel, Windows and Outlook
• Quick learner with an aptitude for custom computer systems
• Previous success and comfort with entering data for extended time periods and limited interruptions

EDUCATION (Required and/or Preferred):

• High school diploma or equivalent required

FIELD OF STUDY (Preferred):

• Business or healthcare related field

SUPERVISION EXERCISED:

N/A

QUALIFICATIONS:

Previous Experience:

• One year experience in medical billing preferred
• One year experience in a fast-paced production environment
• Experience in Microsoft Excel, Word & Outlook

Knowledge, Skills, and Abilities:

• Detail oriented, organized, self-motivated
• Capable of compiling/tracking data to meet deadlines and goals
• Excellent interpersonal skills
• Quick learner with an aptitude for custom computer systems
• Previous success and comfort with entering data for extended time periods and limited interruptions

Certification and Licenses:

N/A

CONTACTS INSIDE AND OUTSIDE THE ORGANIZATION:

Examples of the information needed:

• Daily contact with Department Leadership
• Frequent contact with offshore partners written and oral
• Frequent contact with insurance carriers and facilities via phone calls

WORK ENVIRONMENT AND PHYSICAL DEMANDS:

• Hybrid work schedule (40 hours/week); ability to work well independently in a remote setting or in the office
• Courteous and professional interactions with co-workers and outside parties
• Occasional overtime may be required
• Continuous oral & written communication and listening skills
• High level of integrity, accuracy, honesty, loyalty, and trust
• Office noise and distractions must be minimized to promote quality and productive work
• Job requires a high level of mental awareness and concentration ability
• High level of independence; will usually work in solitude and will assume the responsibilities of prioritizing, and determining workload
• Ability to be flexible with duties and responsibilities

PRIMARY LOCATION:

• Home Based or Lafayette, LA

SECONDARY LOCATION(S):

N/A

CONFIDENTIALITY:

The daily activities of this position will be held in the strictest confidence whether it is in regard to a person, individual and/or a strategic initiative.  Confidentiality must be maintained on any and all documents and/or information processed.

COMPLIANCE:

All SCP Health employees will abide by all policies and procedures including the SCP Health Corporate Compliance Program and will adhere to all applicable local, state, and federal laws.

DISCLAIMER:

The above statements reflect the general duties considered necessary to describe the essential functions of the job as identified and shall not be considered as a detailed description of all work requirements which may be inherent in the position.  They may be subject to change at any time due to reasonable accommodation or other reasons.

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