Patient Account Representative

About the role

Sheridan Memorial Hospital is a top-rated facility in northern Wyoming, known for its commitment to quality healthcare and exceptional patient care. With over 850 skilled employees and 100 specialized providers, the hospital offers a wide range of services and amenities.

Responsibilities

• Verifies accurate encounter information by working Edit Failure in Cerner and making necessary corrections to ensure timely claim submission.
• Makes necessary claims edits in Emdeon to ensure claim submission and reimbursement.
• Contacts patients when additional information is required to file an insurance claim or when the insurance company requests additional information.
• Stays informed about changes in various payors such as Medicare, Medicaid, Blue Cross/Blue Shield, and other third-party payors.
• Processes correspondence and Explanation of Benefits in a timely manner.
• Processes overpayment refunds as required.
• Timely in making contact with insurance companies on claims that have exceeded the time expectation for payment.
• Remains current on Worker’s Compensation and other third-party payors for billing functions.
• Stays current on assigned patient encounter “workQ” in Cerner Revenue Cycle.
• Demonstrates the ability to be flexible, organized, and function well in stressful situations.
• Interacts with patients/families in a professional manner, providing explanations regarding statements, insurance coverage, and ensuring confidentiality of patient records.
• Maintains a good working relationship within the department and with other departments.
• Maintains a professional working relationship with insurance companies.
• Performs other duties as assigned.
• Ensures documentation meets standards and policies.

Requirements

• High school diploma or GED, required.
• Medical terminology, preferred.
• Billing or accounting, preferred.

Qualifications

• Ability to effectively communicate in English, both reading and writing.
• Multi-line telephone knowledge.
• Computer knowledge.
• Ability to operate designated equipment as specified, including computer keyboarding.
• Basic clerical training, including basic filing procedures (both numerically and alphabetically).
• Ability to work under pressure with time constraints.
• Basic knowledge of medical record content and sequence.
• Ability to function independently with minimal direction.