Post Payment Review Analyst - Government

Northside Hospital is award-winning, state-of-the-art, and continually growing. Constantly expanding the quality and reach of our care to our patients and communities creates even more opportunity for the best healthcare professionals in Atlanta and beyond. Discover all the possibilities of a career at Northside today.

OCCUPATIONAL SUMMARY

Reconciles contractual adjustments and payments for Medicare and Medicaid accounts and ensures balances are correct.

PRIMARY DUTIES AND RESPONSIBILITIES

1. Reviews remittance advices for Government accounts to ensure that proper contractual adjustments and payments have been posted.
2. Determines contractual adjustments for those accounts not adjusted at final bill.
3. Changes financial classes on accounts with patient liability balances, secondary insurance balances and accounts denials.
4. Controls money movements on the patient's accounts to ensure that the correct balances are maintained at all times.  Corrects any misapplied payments that occur.
5. Reviews credit balances to determine the application of the credit amounts by investigating possible reversal of contractual or discounted amounts.
6. Reviews late charge/credit report to properly apply contractual adjustment and refer other accounts to the biller for late charge billing.
7. Practices proper safety techniques in accordance with hospital and departmental policies and procedures. Immediately reports any mechanical or electrical equipment malfunctions, unsafe conditions, or employee/patient/visitor injury‑accident to Manager.

REQUIRED:
1. High School diploma or equivalent and one (1) year experience in patient accounting or healthcare reimbursement; OR Associates Degree in Business or related field. 2. Good communication skills, and extensive 10 key and typing skills. 3. General knowledge of HMO/PPO contracts and credit balances.
PREFERRED:
1. Medicare/Medicaid remittance advise experience. 2. Computer experience. 3. B.S. degree in Business.