Account Representative

About the role

National Jewish Health is seeking a dedicated and detail-oriented Account Representative to support the Patient Financial Services team. This on-site role, based in Glendale, Colorado, plays an important part in ensuring accurate processing of accounts receivable, consistent follow up on outstanding claims, and strong service for both patients and payors.

Responsibilities

• Supports patient accounts receivable through billing, claim follow up, appeals, and account resolution
• Applies working knowledge of medical reimbursement policies, medical terminology, and insurance claim procedures
• Demonstrates familiarity with Medicare, Medicaid, Workers Compensation, Managed Care plans, and Commercial Payors
• Provides attentive customer service and patient advocacy while resolving standard questions and issues
• Uses sound judgment to address moderately complex account matters and recommend appropriate next steps

Requirements

• Approachable, knowledgeable, motivated, and able to problem solve effectively

Qualifications

• Education: High school graduate or equivalent required. Some college level course work, preferred.
• Work Experience: A minimum of (2) years of recent and related healthcare experience is required. A minimum of two (2) years in hospital billing/collection/follow up, accounting and customer service environment is preferred.

Skills

• Thorough understanding of CPT, HCPCS & ICD-10 codes, HCFA and UB04 claim forms, DRG, insurance benefits including authorizations/referrals
• Works daily with automated worklist, ATB and or assigned special projects in the patient accounting system to perform account audits of insurance and patient payments
• Utilizes claims editing software and/or payor software to review claims history in order to address and resolve payment delays and/or incorrect payments
• Maintains ability to read and comprehend all payors’ claims adjudication vouchers, explanation of benefits (EOB), or electronic remittance advice (ERA)
• Utilizes vouchers, EOBs, and ERAs to help confirm proper processing of claims and appropriate levels of reimbursement
• Maintains a current and thorough knowledge of regulatory and procedural requirements related to the assigned account workload
• Knowledge of applicable contracted payor documents including the contract matrix and state and federal regulations are required
• Contacts insurance companies or clients and uses proper negotiation or persuasion techniques to elicit payment promise or account resolution
• Processes all refunds, payment transfers and adjustments for account workload according to established Patient Financial Services (PFS) policies
• Communicates regularly with PFS Supervisor or Manager regarding high-risk accounts
• Responds timely (within 24 hours or next business day) to account inquiry calls from patients or insurance companies
• Researches claims or account questions with responsible department and provides customers with requested financial information or refers them to other resources at National Jewish Health
• Provides PFS Supervisor and reports weekly productivity statistics and reports workload fluctuations (backlog or shortages) in a timely manner
• Maintains individual goals established by PFS management
• Actively participates in team and departmental meetings by sharing ideas for improved work processes in PFS and performs as a back-up to staff absences and vacancies, as necessary

Benefits

• Comprehensive Medical Coverage
• Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA) available to pair with some plans
• Paid Time Off
• Dental & Vision Plans
• Retirement Savings
• Wellness Incentives
• Tuition Reimbursement
• Child Care Assistance
• Loan Forgiveness
• Disability & Life Insurance
• Voluntary Benefits
• Exclusive Discounts

Pay

$22.76 - $29.10 per hour

Schedule

Full-time, Monday through Friday, 8:00 AM - 5:00 PM