JOB DESCRIPTION

Accounting Clerk (Commercial Claims Follow-up) Corporate (East 42nd Street) Full-Time -Day

Under the supervision of the Patient Financial Supervisor/Manager, performs a variety of patient accounting functions, including but not limited to financial verification, preparation of Medicaid applications, billing, processing accounts, payment and/or charge posting, account resolution, follow-up collections (Third party and patient), correspondence/mail distribution/, vender account reconciliations and customer services questions.

RESPONSIBILITIES

• Adheres to the Stratified Process Work Environment utilizing either the On-Trac or Trac system applications.

• Analyzes accounts to resolve issues that result in billing and/or payment delays.

• Prepares schedules on work findings, cash postings, global arrangements (splits) and all other schedule that is assigned.

• Prepares all downloads of billing files from Mainframe System to Clearing House. Transmits all clean claims daily to Clearing House and other direct payers.

• Bills and follow-up on specific specialized accounts receivable (bilingual preferred).

• Interviews potential Medicaid patients before admission, during admission and after discharge of admission to obtain essential documentation to process Medicaid application, financial assistance and/or determine the method of hospital reimbursement. Utilize and input into Medicaid Tracking System (MEMS) when preparation of Medicaid application is determined (bilingual preferred).

• Collects form of payment(s) (deposits), for elective, maternity, international, deductible/co-insurance/co-pay and any other patient responsibility. This collection can be prior admission, during admission and/or after admission(bilingual preferred)

• Obtains and validates patient’s third party health insurance. Coordinates and prioritizes insurance within PFS Systems when more than one (1) valid insurance exists. Validation of third party insurance is obtained via various eligibility systems, calls to third party carriers and/or patients ((bilingual preferred)

• Edits unbilled/unprocessed accounts (billing) using PFS HIS Systems, Clearing House Claim Scrubber and/or any payer websites available for claim correction of billed accounts.

• Bill claims to third party payers either electronically or manually.

• Corrects denials and re-bills accounts through PFS Systems.

• Posts all manual charges into the patient accounts system. Inputs appropriate data elements into PFS Systems for specific charge codes (value codes, condition codes, etc).

• Post payments (manual and electronic kick-outs). Post adjustments and reconcile/disposition accounts when necessary.

• Reconcile payments on accounts to ensure that payments agree with negotiated rates. Reviews listings of accounts to ensure payments are received when there are rate changes and/or annual rate increase within said contracts.

• Follow-up all billed third party/self-pay accounts. These accounts are followed up based on parameters set within area of assignment and can be different based on payer. Follow-up action(s) examples can be rebill of account, transfer, assignment of different and/or correction of insurance data, account resolution, phone call, and inquiry through third part website or call to patient. These are just examples and are not limited to these suggestions.

• Distributes and sorts departmental mail received. Correspondence is noted on individual patient accounts. Correspondence is worked within PFS Systems based on the parameters set with in the department all other is distributed to appropriate work area.

• Requests Medical Records and communicates correspondence with inter-office departments.

• Sends bills to patients for self-pay balances (bilingual preferred).

• Responds to patient calls or written correspondence regarding billing issues. Proper customer service techniques should be used.

• Scan documents of assignment.

• Reconcile vendor accounts. Work payment remittance and closed report/files received by outside vendors.

• Perform the preparation of patient and third party refunds.

• Respond to third party audits.

• Account resolution performed on accounts with credit and debit balances.

• Performs other related duties as required.

• Attends Workshops, weekly unit meets and any other meeting assigned.

• Ensures timely completion of required work assignments.

QUALIFICATIONS

• Education: High School Diploma/GED

• Experience: Excellent communication skills (oral and written)

• The ability to work independently and on a team

• Knowledgeable with the Patient Accounts System(s): Eagle, MEMS, Trac/On-Trac, Cirius, FSS, Cerner, Various InsuranceWebsites preferred .

• Knowledge of Microsoft Excel and Word (35 WPM min).

Collective bargaining unit: SEIU 1199-MSH

SEIU 1199 at Mount Sinai Hospital, 518 - PFS 633 Third Avenue - MSH, Mount Sinai Hospital

REQUIRED SKILLS

Eagle

MS Excel

MS Word

ABOUT US

Strength Through Diversity

The Mount Sinai Health System believes that diversity, equity, and inclusion are key drivers for excellence. We share a common devotion to delivering exceptional patient care. When you join us, you become a part of Mount Sinai’s unrivaled record of achievement, education, and advancement as we revolutionize medicine together. We invite you to participate actively as a part of the Mount Sinai Health System team by:

• Using a lens of equity in all aspects of patient care delivery, education, and research to promote policies and practices to allow opportunities for all to thrive and reach their potential.

• Serving as a role model confronting racist, sexist, or other inappropriate actions by speaking up, challenging exclusionary organizational practices, and standing side-by-side in support of colleagues who experience discrimination.

• Inspiring and fostering an environment of anti-racist behaviors among and between departments and co-workers.

At Mount Sinai, our leaders strive to learn, empower others, and embrace change to further advance equity and improve the well-being of staff, patients, and the organization. We expect our leaders to embrace anti-racism, create a collaborative and respectful environment, and constructively disrupt the status quo to improve the system and enhance care for our patients. We work hard to create an inclusive, welcoming and nurturing work environment where all feel they are valued, belong and are able to advance professionally.

Explore more about this opportunity and how you can help us write a new chapter in our history!

“About the Mount Sinai Health System:

Mount Sinai Health System is one of the largest academic medical systems in the New York metro area, with more than 43,000 employees working across eight hospitals, more than 400 outpatient practices, more than 300 labs, a school of nursing, and a leading school of medicine and graduate education. Mount Sinai advances health for all people, everywhere, by taking on the most complex health care challenges of our time — discovering and applying new scientific learning and knowledge; developing safer, more effective treatments; educating the next generation of medical leaders and innovators; and supporting local communities by delivering high-quality care to all who need it. Through the integration of its hospitals, labs, and schools, Mount Sinai offers comprehensive health care solutions from birth through geriatrics, leveraging innovative approaches such as artificial intelligence and informatics while keeping patients’ medical and emotional needs at the center of all treatment. The Health System includes approximately 7,400 primary and specialty care physicians; 13 joint-venture outpatient surgery centers throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and more than 30 affiliated community health centers. We are consistently ranked by U.S. News & World Report's Best Hospitals, receiving high "Honor Roll" status, and are highly ranked: No. 1 in Geriatrics and top 20 in Cardiology/Heart Surgery, Diabetes/Endocrinology, Gastroenterology/GI Surgery, Neurology/Neurosurgery, Orthopedics, Pulmonology/Lung Surgery, Rehabilitation, and Urology. New York Eye and Ear Infirmary of Mount Sinai is ranked No. 12 in Ophthalmology. U.S. News & World Report’s “Best Children’s Hospitals” ranks Mount Sinai Kravis Children's Hospital among the country’s best in several pediatric specialties. The Icahn School of Medicine at Mount Sinai is ranked No. 14 nationwide in National Institutes of Health funding and in the 99th percentile in research dollars per investigator according to the Association of American Medical Colleges. Newsweek’s “The World’s Best Smart Hospitals” ranks The Mount Sinai Hospital as No. 1 in New York and in the top five globally, and Mount Sinai Morningside in the top 20 globally.

The Mount Sinai Health System is an equal opportunity employer. We comply with applicable Federal civil rights laws and does not discriminate, exclude, or treat people differently on the basis of race, color, national origin, age, religion, disability, sex, sexual orientation, gender identity, or gender expression. We are passionately committed to addressing racism and its effects on our faculty, staff, students, trainees, patients, visitors, and the communities we serve. Our goal is for Mount Sinai to become an anti-racist health care and learning institution that intentionally addresses structural racism.”

EOE Minorities/Women/Disabled/Veterans

Requisition ID : 3013593