• Job Description

  Req#: JR127058

  We are more than a health system. We are a belief system. We believe wellness and sickness are both part of a lifelong partnership, and that everyone could use an expert guide. We work hard, care deeply and reach further to help people uncover their own power to be healthy. We inspire hope. We learn, grow, and achieve more – in our careers and in our communities.

  Job Description Summary:

  Responsible for overseeing all functions related to billing department. This includes: obtaining Prior Authorizations for all medications, resolution of denied claims, electronic claims submission (If available) and other billing duties as assigned. Responsible for coordination of drug procurement. Responsible for scheduling all patients and coordination of care with ordering physician offices. Responsible for ensuring quality standards are met and all reporting functions are accurate and submitted in a timely manner.

  Responsibilities And Duties:

  60%
  Responsible for revenue cycle processes including prior authorizations, insurance claims submission and follow-up in accordance with established policies and procedures, benefit verification, patient enrollment with various Risk Evaluation and Mitigation Strategy REM s programs and financial assistance programs
  20%
  Patient appointment scheduling including patient lodging and transportation set up
  10%
  : Work collaboratively with hospital personnel management team to address processes that affect revenue cycle. Work with ordering physicians office to obtain correct clinical information to schedule patient. Work directly with reimbursement account managers for the drug manufacturers. Communicate and Train associates on new policies and procedures put in place.
  5%
  : Stay current on all managed care issues Medicare and Medicaid regulations, and other third party payer requirements ensuring correct authorization of CPT, ICD-10 and HCPCS. Stay current on all medications and regimens used in infusion centers.
  5%
  : Generate monthly reports and provide analysis on financial trends with in infusion centers The major duties/ responsibilities and listed above are not intended to be all-inclusive of the duties, responsibilities and to be performed by associates in this job. Associate is expected to all perform other duties as requested by supervisor.

  Minimum Qualifications:

  High School or GED (Required)

  Additional Job Description:

  Additional Job Description

  Medical billing and CPT/ICD coding Experience . Medical terminology and medical computer billing applications knowledge. Proficient in Microsoft Excel. Three to five years ’ Experience with revenue cycle or equivalent area.

  Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities are subject to change. Other duties may be assigned as needed by leadership based on business need.

  Work Shift:

  Day

  Scheduled Weekly Hours :

  40

  Department

  Corporate Pre Access

  Join us!
  ... if your passion is to work in a caring environment
  ... if you believe that learning is a life-long process
  ... if you strive for excellence and want to be among the best in the healthcare industry

  Equal Employment Opportunity

  OhioHealth is an equal opportunity employer and fully supports and maintains compliance with all state, federal, and local regulations. OhioHealth does not discriminate against associates or applicants because of race, color, genetic information, religion, sex, sexual orientation, gender identity or expression, age, ancestry, national origin, veteran status, military status, pregnancy, disability, marital status, familial status, or other characteristics protected by law. Equal employment is extended to all person in all aspects of the associate-employer relationship including recruitment, hiring, training, promotion, transfer, compensation, discipline, reduction in staff, termination, assignment of benefits, and any other term or condition of employment

  Remote Work Disclaimer:

  Positions marked as remote are only eligible for work from Ohio .

• About the company

  OhioHealth is a not-for-profit system of hospitals and healthcare providers located in Columbus, Ohio and surrounding areas.

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