Senior Representative Patient Account Collect

Responsibilities

• Performs collecting, reconciliation, credit balance resolution, research, correspondence and independent problem solving.
• Reconciles complex, multi-payment accounts.
• SUBMIT appeals letters on underpaid claims as directed.
• Interprets payer contracts to determine if payment and PCON adjustment is accurate.
• Reviews EOB's for denials, along with posting corrected adjustments in order to balance accounts.
• Identifies needs for process improvements and creating/enhancing processes in the PFS department.
• Promotes positive teamwork within department and among employees.
• Works with all hospital departments for proper coding and billing procedures.
• FOLLOWS all departmental, hospital, and regulatory policies and procedures, including HIPAA requirements.
• UTILIZES top customer service skills with all customers: patients, government agencies, commercial insurances, other hospital departments, physicians' offices and attorneys' offices.

Essential Functions

• RECONCILES accounts on a daily basis to determine underpayment, overpayment or contractual adjustment correction.
• UTILIZES technical ability and understanding of applicable insurance contracts and regulations.
• MaintAINS current knowledge of regulatory billing requirements for specified payors.
• ATTENDS in-services/continued education.
• INTERPRETS data processing reports and APPLIES the information as needed for daily departmental productivity.
• TRAINs other staff members on reconciliation techniques and other aspects of the position.

Requirements

• 5 years Billing or collections - Preferred
• 18 months patient accounts experience - Required
• 18 months billing, collection or Medicare/Commercial billings - Required