Patient Account Rep II

Responsibilities

• Responsible for all or part of the following: billing and collecting, research, correspondence, payment and adjustment posting, charge entry, prior authorization, and a host of other duties to assure timely reimbursement to the medical provider.
• Demonstrates independent problem-solving skills of account error necessary to bring the account balance to zero within established time frames.
• Responsible for research and secure payment for insurance accounts:
• Follow up required daily accounts based on work queue assignment to reduce the A/R
• Submit appeal letters on unpaid and underpaid claims
• Participate in accounts receivable collections projects as needed to meet department goals
• Contact insurance companies to follow up on denials and correspondence
• Contact patients regarding insurance related issues
• Research recoups and repayments to assure that payments are accurate and comply with Medicare and Managed care contracts payment methodologies
• Work the electronic denial file (835b) to ensure clean claim submission
• Review Charge review work queues as assigned
• Responsible for research and secure payment for patient balances:
• Follow up required daily accounts based on account work queue assignment to reduce the cash pays A/R
• Submit final letters to delinquent accounts
• Answer incoming patient calls
• Provide support to the clinics as needed during patient care hours
• Collection calls to patients to collect past due balances
• Process credit card payments and post within the patient billing system
• Set up payment plans for patients
• Review statements to ensure accuracy
• Acts as a liaison between patient, practice and insurance carrier regarding complaints and problems
• Work with statement and bad debt vendors on disputes and ensure accuracy of accounts
• Work return mail to update accounts to ensure accuracy
• Performs routine data entry and/or review of claim edit work queues:
• Input charges for physician billing
• Correct denials that have dropped to the claim edit work queues timely
• Maintains current knowledge of regulatory billing requirements for the specified payers and various specialty specific limitation or payer expectations
• Processes the electronic claims batch daily and initiate the printing of paper claims
• Review Charge review work queues as assigned
• Handles all payments and correspondence received in the central business office:
• Processes all EFT/ERA, lockbox, mail, POS, phone payments
• Processes credit cards
• Creates payment batches and scans all correspondence into patient billing system
• Processes deposits for all incoming payment, including POS from multiple clinics
• Sets up courier service for new clinics
• Posts payments and denials into patient billing system
• Processes ERA payments and works error work queue
• Follows departmental functions:
• Prioritize work to minimize interruptions and increase efficiency in collections process
• Participate in daily DMS huddle, and all department meetings
• Provide five-star customer service, to include patients, coworkers, vendors and management
• Establish and maintain and efficient filing system
• Maintain clean and organized work area
• Communicates and engages effectively with others
• Communicates and participates in training classes as needed to keep current with daily operations
• Work in a team environment and participate in constructive feedback

Qualifications

• High School Diploma or GED - Required
• 2 years healthcare billing and collections experience in a medical practice or healthcare organization - Required
• 5 years healthcare related medical professional billing and collections experience. - Preferred