Monument Health

Financial Planning and Analysis

• Perform duties necessary to ensure the proper interpretation, processing, recording, approval and payment of inpatient and outpatient medical claims.
• Accurately reviews information for processing claims into a computerized system in accordance with the primary payer specifications and billing guidelines.
• Conduct timely follow up of claims.
• Use tools provided to track and trend patterns of claim submission issues that might require Compliance and Charge master staff to resolve, or HIPAA transaction code set review.
• Research payer requirements and offer suggestions to leadership for claims submission issues.
• Maintain and update appropriate system documentation to provide information regarding claim processing to internal or external customers.
• Identify unresolved requests of patient responsibility and transfers account to self pay.
• Perform duties and provides best customer service using behaviors that demonstrate responsibility and accountability.
• Participate in departmental activities related to performance improvement and quality control.
• Demonstrates a working knowledge of denial follow up and first level appeals.
• All other duties as assigned.

Biller I