Business Office Assistant
Grafton-WV-26354-United States
At Grafton City Hospital, we are committed to providing exceptional healthcare services with compassion, integrity, stability, vision, and innovation. Since 1945, our hospital has been the cornerstone of the Grafton community, serving patients and families with personalized care and advanced medical treatment. As one of the largest employers in Taylor County with over 100 dedicated and caring employees, we are committed to employing our talents and abilities to solve any challenges our patients and communities face. Grafton City Hospital is centrally located less than 30 miles from Morgantown, Bridgeport, and Fairmont, WV.
JOB SUMMARY
Primary Responsibilities:
- Posts electronic and manual payments received from insurance companies accurately and in a timely manner
- Analyzes EOB information, including co-pays, deductibles, co-insurance, contractual adjustments, denials, and more, to verify the accuracy of patient balances
- Develops a strong understanding of assigned payers’ processes and habits and helps identify payment trends
- Verifies that posted payments align with bank account funds per the [daily, weekly] reconciliation log
- Researches and reconciles unidentified payments to ensure they are applied to appropriate accounts.
- Properly documents and enters all transactions into patient accounts within CPSI
- Refers accounts to follow-up representatives to pursue additional payment, as appropriate
- Assists other payment posting areas (e.g., self-pay) as necessary
- Performs other duties as assigned
- Adheres to Grafton City Hospital’s policies and procedures
- Maintains HIPAA compliance and follows all applicable state and federal regulations
Additional Business Office Duties:
- Examines denied and underpaid claims to determine reasons for discrepancies
- Communicates directly with payers to follow up on outstanding claims, resolve payment variances, and achieve timely reimbursement
- Provides payers with specific reasons for suspected underpayments and analyzes denial reasons given by payers
- Works with management to identify, trend, and address root causes of denials; helps pinpoint strategies for reducing A/R
- Maintains a thorough understanding of federal and state regulations, as well as specific payer requirements and explanations of benefits, in order to identify and report billing compliance issues and payer discrepancies
- Updates and maintains accurate files on each payer, including contact names, addresses, phone numbers, and other pertinent information; thoroughly documents all interactions with payers.
- Effectively handles all communications, including telephone and email, from payers and departments within the business office
- Utilizes payer scorecards, identifies high-risk accounts, and prioritizes follow-up efforts
- Participates in continuous quality improvement efforts on an ongoing basis, establishing goals with supervisors and tracking progress
- Demonstrates initiative and resourcefulness by making recommendations and communicating trends and issues to management
- Understands and maintains compliance with HIPAA guidelines when handling patient information
- Performs other duties as assigned
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MINIMUM QUALIFICATIONS
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Education: High School graduate or equivalent with advanced courses in bookkeeping or accounting preferred.
Experience: 2 years’ business office experience with public contact preferred. Knowledge of clinic billing procedures. Excellent verbal and written communication skills along with strong time management abilities. Should be comfortable in an automated billing environment, dealing with confidential information, have proper phone etiquette, and be computer-literate.
Licensure/Certification: N/A
Grafton City Hospital is an equal opportunity employer.
PI274180731
