Patient Account Rep Senior

About the role

Medicare Patient Account Representative, Senior is responsible for all Medicare insurance collections of accounts to ensure that PFS is capturing all revenues as timely and efficiently as possible. This position takes ownership of their accounts and eliminates barriers to ensure timely and correct payment including involvement with payors upper management, when necessary. This position will have working knowledge and understanding of Medicare payment methodologies to ensure prompt and accurate reimbursement. This position must be able to utilize and understand many complex and varying State and Federal statutes and regulations, guidelines, and systems, and perform the account follow-up function with all Medicare government agencies to obtain maximum and correct reimbursement of accounts receivables. This position proactively works with all payors and internal resources to identify and resolve issues that hinder account payment. Applies independent judgment, research, and knowledge to audit Medicare payments, denials, appeals and billing issues. This position offers you the opportunity to work from home (WFH) after all training has been completed. Once completed you will need to be available to come into the office for additional training, meetings etc., as needed.

Responsibilities

• Provide prompt and courteous customer service to all internal and external customers
• Use critical thinking to research, review, and follow-up on all accounts
• Communicate effectively in verbal and written form
• Analyze documentation and resolve patient, billing and/or collection issues appropriately and timely
• Work independently with minimal supervision
• Identify and analyze problems in a timely manner and independently initiate appropriate actions to resolve problems or issues
• Be at work and on time, follow organization rules and procedures and directions from a Coordinator/Lead or other member of the Management staff
• Adhere to all confidentiality policies and procedures and carry out all tasks in a pleasant and respectful manner
• Make suggestions for enhancements throughout the department and continually seek opportunities to improve current policies, procedures, and practices
• Recognize and perform essential duties and help others or perform other required tasks when own assignments are completed
• Perform other duties as assigned by management
• Use critical thinking while reviewing billing and collection notes in the financial computer system to ensure that the appropriate action is taken within the billing and collection process and to ensure correct hospital reimbursement
• Prioritize and multitask

Requirements

• Minimum 2 years Acute Care In-Patient and Out-Patient Medicare Hospital Collections experience (required)
• Understanding of Medicare insurance collection processes including denial resolution and appeals (required)
• Excellent interpersonal skills
• Positive work ethics
• Knowledge of medical terminology and coding
• Written and verbal communication skills to meet productivity standards
• Microsoft Office and Outlook experience

Qualifications

• High School diploma, GED equivalent (preferred)
• Business-related courses (preferred)
• AA Degree or medical field certificate (preferred)
• Bi-lingual (preferred)

Pay

$25.22/hr - $36.57/hr. Placement in the pay range is based on multiple factors including, but not limited to, relevant years of experience and qualifications. In addition to base pay, there may be additional compensation available for this role, including but not limited to, shift differentials, extra shift incentives, and bonus opportunities.

Schedule

Full-time, Days (8hr shifts). Predominantly Remote after training.

Benefits

We offer high quality health insurance plan options, so you can select the best choice for your family. Check out our MemorialCare Benefits for more information about our Benefits and Rewards.