Patient Account Representative

Duties And Responsibilities

• Follow-up with payers to ensure timely resolution of all outstanding claims, via phone, emails, fax or websites
• Review and updates all patient and financial information accurately as given
• Verify that information is accurate as to individual or insurance company responsible for payment of bill
• Maintain accuracy of all billings
• Monitor Medicaid/Healthy Options coupons to assure services are billed within expected timeframes
• Bill all hospital services to primary insurer or patient correctly and within expected timeframe
• Follow up with insurance companies on all assigned accounts within expected timeframe
• Explain hospital regulations with regard to methods for payment of accounts and maintains complete working knowledge of insurance regulations and hospital insurance contracts
• Identify and report underpayments and denial trends
• Analyze, identify and resolve issues causing payer payment delays; Initiate appeals when necessary
• Manipulate excel spreadsheets and communicate results

Qualifications

• High School Diploma or equivalent required
• Medical Billing and Coding certification preferred, but not required
• Experience in Hospital/Facility billing required
• 2-3 years’ experience in insurance collections, including submitting and following up on claims
• Basic knowledge of healthcare claims processing including: ICD-9/10, CPT and HCPC codes, as well as UB-04
• Ability to use various workflow systems and client host systems such as STAR, SMS, EAGLE and EPIC, as well as other tools available to them to collect payments and resolve accounts
• Working knowledge of the insurance follow-up process with understanding of the fundamental concepts in healthcare reimbursement methodologies
• Understanding of government, Medicare and Medicaid claims
• Basic math and typing skills
• Proficiency with Microsoft Office Suite
• Strong interpersonal skills, ability to communicate well at all levels of the organization
• Strong problem solving and creative skills and the ability to exercise sound judgment and make decisions based on accurate and timely analyses
• High level of integrity and dependability with a strong sense of urgency and results oriented
• Excellent written and verbal communication skills required