St. Joseph's/Candler
Payment Compliance Representative
This job is now closed
Job Description
- Req#: 10804
- Position Summary
- The Payment Compliance Representative is responsible for collections of denied and underpaid claims. The Payment Compliance Representative performs appeal and follow-up activity on all accounts denied or underpaid to final resolution.
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- Education
- High School Diploma - Required
- Associates - Required
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- Experience
- 2-3 Years Patient accounting or denial department setting - Preferred
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- License & Certification
- None Required
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- Core Job Functions
- Evaluates denied and underpaid claims for best possible approach to facilitate resolution. Works with Payment Data Analyst to ensure correctness of denials and underpayments.
- Complies and submits required documentation for appeal. Works with payer provider representative for contract issues; Ensures appeals are completed and filed per payer time limits.
- Follows-up with payer and vendor for appeal status. Monitors account through to final resolution. Documents all actions taken in appropriate computer system.
- Meets department production standards. Meets department quality standards
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About the company
St. Joseph's/Candler is the leading health system in Savannah, Ga., offering comprehensive services and state-of-the-art medical technologies in the region.
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