Cash Operations Enrollment Specialist
Steward Health Care System LLC ("Steward") is a fully integrated, physician-led national health care services organization committed to providing the highest quality of care in the most cost-efficient manner in the communities where our patients live. Steward - the largest privately held health care company in the U.S. - owns and operates 35 community hospitals across nine states, serves over 1,000 distinct communities and employs approximately 40,000 health care professionals. In addition to our hospitals, the Steward provider network includes 4,800 providers, 25 urgent care centers, 87 preferred skilled nursing facilities, substantial behavioral health offerings, over 7,300 hospital beds under management, and approximately 1.5 million full risk covered lives through the company's managed care and health insurance services.
Steward Medical Group (SMG), Inc. is Steward's multi-specialty group practice with over 4,500 employees including over 1,800 physicians and advanced practitioners. SMG operates approximately 450 practice locations throughout Massachusetts, Southern New Hampshire, Rhode Island, Pennsylvania, Ohio, Florida, Utah, Arizona, Texas, Louisiana and Arkansas, and provides more than 4 million patient encounters per year.
This position is responsible for Steward Medical Group follow up operations, meeting goals and company objectives, in assigned areas of cash posting, collections, payment validation, customer service and correspondence using the Athena web system. Associate must ensure that all process meet all government mandated procedures for integrity and compliance. Performs all responsibilities in a prompt and efficient manner. Must be detail oriented meeting multiple deadlines while working independently and/or in small groups. Revenue Cycle Payment Enrollment Specialist knowledge is required and Athena experience is preferred. The Payment Enrollment Specilialist reports to the Cash operations supervisor or manager.
• Accurately enroll or update payer enrollments across the enterprise.
• ERA/EFT enrollment.
• Review incoming correspondence for opportunities to convert to electronic methods.
• Maintaining and reviewing the enrollment worklist.
• Transfer payments to and from the various Steward vendors.
• Work manager holds in Athena related to claims.
• Resolve patient financial service issues related to cash.
• Resolve Unapplied cash in patient accounting system.
• Upload remits for posting in Athena.
• Sort and direct correspondence.
• Work patient account system worklists.
• Process refunds for patient & insurance.
• Maintains strict confidentiality and adheres to all HIPAA guidelines/regulations.
Required Knowledge & Skills:
• 2-3 years experience with medical billing/collection; physician billing experience preferred.
• 2-3 years expericece with Cash Operations including balancing, reconciliation and EOB interpretation
• Knowledge of basic medical coding/terminology and third-party insurance operating procedures and practices a plus.
• Experience with patient accounting systems and billing/claim submission software; specific Athena Health experience a plus.
• Knowledge of revenue cycle and/or business office procedures.
• Ability to utilize basic Microsoft Office programs
• Moderate to advance level of excel knowledge-including pivot tables
• Highly detail oriented and well organized.
• Ability to read, understand and follow oral and written instructions.
• Ability to establish and maintain effective working relationships and communicate clearly with customers and insurance companies both within and outside of Steward.
I. Education: Associates degree or a combination of High School and relative work expieriece.
II. Experience (Type & Length): 5 years Experience in revenue cycle operations. 2 plus years in Cash Operations
III. Five plus (5+) years of relevant work experience.