Patient Account Representative
2 months ago
This position will be responsible for insurance follow-up from third party payers, to be responded to in a courteous, timely manner.
Representatives will process patient accounts to third parties and resolve accounts to a zero balance. Expertise in all third-party billing and contracted payment agreements. The account representative is required to have good writing skills and ensure proper account documentation. Verbal communication required for relaying issues/concerns with problem accounts to supervisor and mangers.
Job Functions
- Responsible for the resubmission of primary, secondary, and tertiary claims per respective regulations and policies.
- Communicate with third-party representatives as necessary to complete claims processing and /or resolve problem claims.
- Follow-up daily on post processing activity including but not limited to, rejected billings, adjustments, and rebilling, and denied claims for accounts that are greater than 30 days old.
- Maintain accounts receivable detail by use of on-line system documentation.
- Maintains standards per payer for percentage accounts >90 days.
- Works minimum standard number of accounts per payer per day.
- Meets or exceeds collection goals by payer each month.
- Works all assigned accounts at least once every 15 or 30 days, depending on balance.
- Participates in educational activities and attends monthly department staff meetings.
- Maintains confidentiality: adheres to all HIPAA guidelines/regulations.
Minimum Qualifications
- HS diploma or General Education Degree
- Three to Five years’ experience in medical office billing preferred.
- Knowledge of ICD-10 /HCPCS/CPT Coding
- Basic Knowledge of third party insurance plans
- Familiarity with medical terminology helpful.
Skills
- Must be able to communicate effectively when in contact with insurance carriers, third party payers and patients.
- Must be able to learn and understand patient accounting policies and procedures and how the Accounts Receivable computer system works.
- Must be able to use a computer, calculator, fax machine. Copier and other office tools efficiently to meet performance goals.
- Intermediate knowledge of Microsoft Word and Excel: and the ability to learn innovative programs and systems.
- Dependable in both production and attendance.
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