JOB SUMMARY

Responsible for obtaining, posting, and balancing all electronic remittances to bank electronic fund transfers. Position will investigate and correct any discrepancies.

Job Specific:

Responsible for downloading Insurance payments, Explanation of Benefits or Remittance Advices from the electronic claims vendor daily. (EF) Initiates electronic batch posting into Accounts Receivables software from electronic claims vendor. (EF) Balances batch postings to electronic Explanation of benefits and/or Remittance Advices. (EF) Responsible for balancing electronic postings to amounts transferred to bank account via electronic funds transfers. (EF) Manually posts electronic funds transferred to the bank that are not set up to auto-post to patients' accounts. (EF) Prepares daily report of all electronic funds transferred and posted into patient accounting system. (EF) Review Explanation of Benefits and/or Remittance Advices for denials, posting appropriate adjustment code to relieve patient account(s) of denied or non-covered items not billable to patient/guarantor. (EF) Distributes copies of denied claims to appropriate collector for follow-up or appeal process. (EF) Communicates with management and accounting any bank discrepancies identified. (EF) Investigates source of unidentified payments or lump-sum payouts by Medicare, Medicaid, or other insurance payers. (EF) Maintains established policies and procedures, objectives, quality assurance standards. (EF) Assists in the care and maintenance of department equipment and supplies. Participates in educational programs and inservice meetings as required.

Hospital:

Adheres to organization-wide and other applicable policies and procedures. Day-to-day performance complies with the hospital's Service Excellence Behavioral Expectations. Performs within the prescribed limits of the hospital's Ethics, Compliance and Confidentiality Program guidelines. Performs within professional Scope of Practice at all times.

Other Duties As Assigned:

Nothing in this job description restricts management's right to assign or reassign duties and responsibilities to this job at any time. Minimum Requirements

EDUCATIONAL REQUIREMENTS

Required:

High School Diploma Preferred:

One (1) to two (2) years of college

EXPERIENCE

Required:

Previous medical claims billing or three (3) years' of hospital business office experience

SPECIAL SKILLS AND ABILITIES

Required:

Computer and typing skills

COMPANY PROFILE

Citizens Medical Center is a not-for-profit, community hospital known for compassionate patient care, clinical expertise, and bringing advanced medical services to the South Texas region since 1956. Today, Citizens is a 317-bed acute care hospital with over 1,200 employees. Voted "Best of the Best" hospital in Victoria for 14 consecutive years, Citizens Medical Center is a level III Trauma Center, currently renovating its 24/7 Emergency Department that includes an onsite medical helicopter. Citizens has a comprehensive Community Cancer Program that includes two linear accelerators and HDR brachytherapy. Citizens is recognized for its outstanding cardiology program which includes a nationally accredited Chest Pain Center and is a Primary Stroke Center. Citizens also includes a comprehensive, accredited Bariatric Surgery program, Birth Center with labor and delivery, an imaging and surgery center, sleep study center, state-of-the-art rehabilitation and fitness center, urology center and daVinci robotics minimally invasive surgery options, a home health agency, and has a long history of providing continuing education for healthcare providers and the community. Citizens Medical Center is looking for employees who display respect and enthusiasm for patients, visitors, and coworkers, and who consistently uphold the organization's commitment to providing outstanding outcomes and an excellent experience. We are an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity or expression, pregnancy, age, national origin, disability status, genetic information, protected veteran status, or any other characteristic protected by law.

BENEFIT OFFERINGS

Health Medical, Dental, Vision

STD, LTD

Disability Supplemental Life, AD&D Flexible Spending (FSA) Employer paid life insurance Retirement/Investment Defined Benefit Pension Plan 457(b) Deferred Compensation Well-Being Benefits Paid Time Off & Sick leave Bereavement leave, Jury Duty/Witness Service Hospital-paid & administered annual immunizations HealthPlex (gym) membership discount YMCA partnership discount for childcare Employee Assistance Programs