St. Joseph’s/Candler Health System
The Claims Editor is responsible to ensure all insurance claim edits and or rejections from Meditech and SSI are reviewed, analyzed and resolved. Ensure that the claims are compliant with federal and state regulations. Responsibilities include but are not limited to billing, prompt adding and follow-up of SSI tickets to enhance billing efficencies. Understands the laws that govern the billing.
Education High School Diploma - Preferred
Experience 2-3 Years Healthcare claims and Reimbursement - Required
License & Certification None Required
Core Job Functions Performs claims editing to ensure a positive cash flow. Accurately screens and processes assigned claims edits and rejections. Meets departmental time standards for corrections. Rebills claims when appropriate.
Provides oversight of claims editing. Reviews and analyzes claims editing reports. Determines the source of errors and rejections. Recommends process changes within Patient Accounts and other departments to ensure efficiency and compliance.
Creates SSR inquiries to SSI for creation of edits for more efficient workflow.
Works collaboratively with others to achieve efficiency and accuracy. Seeks answers/assistance from the appropriate source. Keeps up to date on billing/compliance rule changes
Not the right fit? Join our Professional Talent Network and learn more about allcurrent and future job opportunities.
Learn more about the many benefits available to SJ/C co-workers. From wellness programs and insurance options to child care and housing opporunities, SJ/C invests in the health and well-being of our co-workers in many ways. Click here to learn more.
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Education High School Diploma - Preferred
Experience 2-3 Years Healthcare claims and Reimbursement - Required
License & Certification None Required
Core Job Functions Performs claims editing to ensure a positive cash flow. Accurately screens and processes assigned claims edits and rejections. Meets departmental time standards for corrections. Rebills claims when appropriate.
Provides oversight of claims editing. Reviews and analyzes claims editing reports. Determines the source of errors and rejections. Recommends process changes within Patient Accounts and other departments to ensure efficiency and compliance.
Creates SSR inquiries to SSI for creation of edits for more efficient workflow.
Works collaboratively with others to achieve efficiency and accuracy. Seeks answers/assistance from the appropriate source. Keeps up to date on billing/compliance rule changes
Not the right fit? Join our Professional Talent Network and learn more about allcurrent and future job opportunities.
Learn more about the many benefits available to SJ/C co-workers. From wellness programs and insurance options to child care and housing opporunities, SJ/C invests in the health and well-being of our co-workers in many ways. Click here to learn more.
#J-18808-Ljbffr