Shire Jobs

JOB REQUIREMENTS: Love + medicine is who we are, it\'s what we do, it\'s why people want to work here. If you\'re looking for a job to love, apply today. Scheduled Weekly Hours:40 This position is possible to work in a Hybrid model once fully trained. Must report to home location of Hillsboro, WI for meetings and work at least 2 days per week in house. Not fully remote. Job Description: Major Responsibilities: Works collectively with payors, patients and internal contacts to identify and rectify billing issues resulting in reimbursement and final disposition of claims. Verifies accuracy of payment for correct reimbursement. Maintains knowledge of all regulations by continually enhancing education specific to federal regulations, payer communications, federal registers and contractual guidelines to ensure compliance. Is familiar with government and commercial Web Sites and can research and interpret them effectively. Works with our internal and external customers to maintain data integrity within patient accounting systems. Works closely with Customer Service, Patient Relations, Risk Management, and Provider Medical Management to provide direction with complicated account inquiries to provide accurate and timely responses to patients resulting in increased overall patient satisfaction. Uses CWS to view patient preferences to communicate with patients including those cared for by Behavioral Health. Performs complex guarantor account reviews on all financial classes including credit balances. Investigates and appeals denials from Third Party Payors by verifying accuracy Performs necessary error corrections and/or initiates a refund request to rectify the guarantor account. Documents all activities/actions taken on an individual patient account within the billing system. Must be familiar with appropriate regulatory and contractual guidelines including HIPAA, in order to review and make corrections as appropriate. Effectively communicates and educates patients on their financial responsibilities to the organization by giving estimates on services, taking payments, setting up payment arrangements and negotiating settlements on accounts under direction of Supervisor/Manager/Director. This would include the guidelines for payments and self pay balances, along with the insurance process and statements they will receive. Actively participates in analysis of work processes and provides feedback to the PBS Managers and PBS Systems Trainers to assist in enhancing overall patient satisfaction and work process improvements. Participates actively in department meetings and assumes additional responsibilities and special projects as assigned. Determines appropriate insurance eligibility and rebills claims with new information. Contacts and works directly with patients when necessary. Identifies and routes to appropriate staff for solving Charge Master Issues. Requests refund checks for... For full info follow application link. EEO/AA/Veterans/Disabilities ***** APPLICATION INSTRUCTIONS: Apply Online: ipc.us/t/376FD0F9F0D94F23