Patient Accounting Representative I

Responsible for accurate and timely action on accounts as it relates to specific responsibilities within Patient Financial Services (PFS). Complies with governmental and managed care rules and regulations. Meets department goals as well as productivity and quality standards. Attends and actively participates in training and education.

Responsibilities

• Posts payments, refunds, and adjustments to accounts within designated time frame.
• Completes assigned work queue within designated time frame.
• Balances receipts, reconciles daily batches, and prepares audit trail in accordance with department guidelines.
• Reviews Explanation of Benefits for incorrect and/or inconsistencies in reimbursement.
• Identifies consistent fee schedule allowable differences and communicates up line for updating.
• Communicates payer trends to management.
• Follows up with insurance companies on denials and insurance inquiries as necessary to resolve the account.
• Provides additional information or documentation as needed to resolve account.
• Notes actions taken on the accounts and verifies and updates insurance as directed by department policy.
• Processes adjustments on accounts as necessary in compliance with department policy.
• Enrolls, validates, and re-validates practitioners’ information with government and commercial payers.
• Updates databases, monitors Medicare, Medicaid, and Commercial payer websites for revalidation notices, and communicates provider changes to contracted health plans and departments utilizing standardized reports.
• Assists with processing applications in accordance with organization's policy, procedures, and health plan requirements.
• Audits provider data to assure accuracy as assigned.
• Communicates roster changes from physician groups.
• Reviews department-specific Epic Charge work queues, makes corrections, and follows up with departments as needed.
• Reviews daily Epic charge router reconciliation report to ensure all charges are filed and interfaced.
• Assists departments with charge error corrections including duplicate, missing, or rejected charges.
• Analyzes revenue trending reports and escalates problems to manager and departments as appropriate.
• Must be able to perform the professional, clinical, and/or technical competencies of the assigned unit or department.

Requirements

• High School Graduate or GED.

Qualifications

• 1 or more years of experience in Epic (preferred).

Time Type: Full time