Credit Rep II

The Credit Rep II t will be responsible for the correction, rebilling, and collection of audited patient accounts as part of the Claims Resolution and Improvement Team. Government payers require that overpayments be returned within 6 days from the date of the identified overpayment. This position is responsible for identifying overpayments and submitting corrected claims or refunds to the appropriate payer to ensure that Intermountain Healthcare meets regulation requirements.
Responsibilities:

Ordering and correcting audited claims to payers within a limited time frame.
Collecting on outstanding accounts to ensure claims have been reprocessed by payers in a timely manner.
Working with facility departments or Ambulatory Coding and Reimbursement and providers to resolve coding errors.
Providing research, using bills and medical records, to validate charges.
Acting as a subject matter expert and resource to others by demonstrating an understanding of government regulations and requirements for overpaid patient account while demonstrating an understanding of charge related policies, procedures, and guidelines.
Creating daily reports to improve payment results and ensuring that corrected claims are processed by the payer within appropriate timeframes.
May complete the Medicare Quarterly report for assigned regions.
May participate in corporate audits, providing input for the development of audit objectives, scopes, and procedures.
Collaborating with team members to interpret and analyze audit results to develop corrective action plans.
Acting with minimal supervision to prepare reports for presentation to management and Intermountain leaders.

Required Qualifications:

Bachelor’s degree or equivalent experience
Three years customer service experience.
One year of experience working in the PSR / Account Resolution department in a role requiring the demonstration of proficiency with policies and procedures, and competence in a wide range of department job functions and responsibilities.
Must have business office experience on Centricity Business
Experience in a role requiring billing or collection experience within the last three years.
Experience working effectively in time sensitive situations, multi-tasking and making prompt, responsible decisions.
Experience in a role requiring strong interpersonal and problem solving skills, and the demonstrated ability to work independently and under pressure with minimal supervision and excellent organizational skills.
One year of experience using word processing, spreadsheet, database, internet and e-mail, and scheduling applications with demonstrated typing proficiency.
Demonstrated ability to work in a high volume fast paced work environment and meet deadlines.
Demonstrated ability to embrace and manage change in a positive and supportive manner.
Demonstrated ability to communicate and problem solve issues professionally and effectively …