Washington, DC30+ days ago
High School Diploma or General Equivalency Diploma (G.E.D.) required Minimum of five (5) years of experience in billing, collections, customer service, or cash posting required Hospital setting experience required Acute care facility experience required, including inpatient stay collection, DRG reimbursement, and Medicare and Medicaid payer experience Certified Patient Account Representative (CPAR - HFMA) or Certified Revenue Cycle Specialist - Institutional (CRCS-I - AAHAM) certification required, and must be retained throughout employment Demonstrated ability to produce accurate Medicare, Medicaid, and commercial payer claims that yield substantiated reimbursement Proficiency in Microsoft Office (Outlook, Excel, Word, PowerPoint); strong basic computer and math skills Strong organization, problem-solving, and time-management skills; ability to work independently in a collaborative environment. Contact insurance carriers as scheduled by the collection tool; communicate clear action plans when adjudication is delayed Identify, review, and resolve denied claims daily; monitor accounts receivable status using Siemens Invision Unity, ePremis, EDM, the Medicaid and Medicare portals, CareFirst, and MCO portals Perform payer remittance and reimbursement posting reconciliation; ensure reimbursement is consistent with payer contractual terms before performing adjustments or billing patient responsibility Review and resolve credit balances accurately; report out-of-the-ordinary circumstances to immediate supervisors for investigation.