OHSS Account Analyst

Department: North Lien Hub



Schedule: Full-time regular, 40 hours/week,



Education: High School Graduate or equivalent.



Licensure/Certification: N/A



Position Summary:



Qualifications:



Experience Required: Must have recent (2-3 years) experience in health care environment; Previous

experience in all ARBIS billing system transactions required; Must have at least 1 year experience

in workers' compensation claims, medical terminology, and collection procedures.



Experience Preferred: Experience with Kaiser Permanente either at regional or medical center

preferred; Experience in medical abstraction and/or billing preferred; Working knowledge of STIX

billing systems preferred.



Knowledge Required: Basic understanding of accounting principles and math is required (must pass

math test).



Knowledge Preferred: Knowledge of CPT codes, ICD-9 codes and procedure codes.



Skills/Abilities Required: Demonstration of high initiative and the ability to keep current in a

high-paced, high-volume work environment required; Computer and keyboarding skills required; Strong

verbal and written communication skills required; Must be assertive communicator with ability to

remain calm in stressful situations and project a positive public image of the organization.



Skills/Abilities Preferred: Microsoft Word and Excel Spreadsheet preferred; Successful completion of

a medical terminology course preferred.



Skills Testing: Typing 30wpm, 10-key by sight; Math test.



Duties: Within Departmental Policies & Procedures, under the direction of the immediate supervisor,

responsibilities include performing collection functions, processing charges/adjustments, and

providing support to meet or exceed the PBS revenue goals. Responsibilities include the following:



1. Contact OHSS payor(s) with timely follow-up



2. Review/analyze accounts in order to obtain payment or to ascertain why payment has not been

received. Works from files



(interim) and/or account listing, which may be system generated or customized



3. Processes charges and re-bills; review /analyze all billing documentation for appropriateness to

OHSS contracts



4. Respond to phone requests and/or correspondence; Perform all customer service duties for payors

and OHSS Clinics



5. Review/analyze and verify correct information has been documented on accounts



6. Report collection activity on a weekly basis via Excel spreadsheet



7. Negotiate and settle accounts within stated parameters for all OHSS payors



8. Process appropriate A/R transactions such as write-off, adjustments, transfers, and refunds

within state parameters



9. Review/analyze medical billing



10. Identify other responsible payors



11. Monitor and report trends for delays in reimbursement (both internal and external)



12. Act as sole interface for OHSS Clinics, employer groups, and internal departments with regard to

OHSS accounts and line of



business



13. Perform all computer functions appropriate to document actions already taken or scheduled to be

taken



14. Develop new guarantor insurance information as necessary



15. Perform other duties as assigned, including but not limited to special projects



Other duties include: Demonstrate legal and ethical responsibility to protect patient and employee

confidentiality; Act as a role model by adhering to regional and local standards, procedures, and

policies when completing all outlined and requested duties and projects; Work in a collaborative

manner with coworkers, promote team effort, and communicate with the immediate supervisor issues as

they relate to performance/process; Demonstrate flexibility in performing primary and other

assignments or projects as needed to maintain operational efficiency; Demonstrate punctuality and

regular attendance to meet department goals and objectives; Adhere to department policies regarding

appropriate dress, absence from work, and requesting time off.