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Representative Patient Accounts

1 month ago

Snellville, United States Advanced Urology Full time
Job DescriptionJob Description

Dr. Jitesh Patel started Advanced with one goal in mind – to do the right thing. We aim to continue that mission here every day. We know that our employees are what makes the difference in the care of our patients – and we always put our employees and our patients first.

Come work with a purpose and with colleagues who care about you. Grow to your full potential and enjoy the reward of providing compassionate and personalized healthcare.

What we offer:

  • A great place to work
  • Dedicated to work life balance
    • Great hours Monday-Friday (NO nights, NO weekends, NO holidays)
    • Paid time off that increases with tenure
  • Committed to growth and development:
    • Education programs that include tuition, certification and license reimbursement
    • Cross training programs for OR RNs and Medical Assistants
  • Passionate about our employees:
    • Employee appreciation and years of service programs
    • Health, dental, vision, life, disability and 401(k)
    • 8 weeks paid maternity/new mother’s leave program
  • All over Metro Atlanta With 15 locations in metro Atlanta, we are sure to have something close to home

Who you are:

  • Driven by a desire to make a difference.
  • Passionate for providing superior healthcare
  • Committed to serving our patients
  • Dedicated to teamwork
  • Positive, Innovative, and Resourceful

MISSION

Reviews claims to make sure that payer specific billing requirements are met by utilizing payer websites, payer payment and medical policies for insurance follow-up to improve cash collection efforts. Review denials for trends and help identify root causes. Work with coding and leadership to draft appeals using all available resources and follow the denial through all appeal levels as needed. The responsibilities also include and are not limited to following-up on claim processing to reconcile patient accounts using all available resources such as payer portals, EOB’s and applying adjustments as needed. Accurately update patient accounts as necessary, and being a reliable partner within our team to provide an exceptional billing and collections service that enhances the patient experience

OUTCOMES

  • Able to navigate through complex information regarding current contracts, insurance plans details, registration, scheduling, referrals, authorizations, and account follow-up in a timely manner.
  • Responds effectively to the reactions and positions of patients and payors to recommend adjustments and bring timely resolution to accounts.
  • Coordinate activity with collections team to ensure timely, accurate rebill of accounts, while facilitating quality improvement through reporting opportunities for increased revenue and decreased denials.
  • Maintains up to date knowledge regarding government and commercial payors status and their insurance products, associated Explanation of Benefits (EOB), and other information related to accounts receivable follow-up.
  • Ensures maximum entitled reimbursement and apply appropriate allowances and adjustments by clearing balances on accounts and pursuing billing of secondary insurance or patients.

COMPETENCIES

Job Related Competencies:

  1. Manages Complexity: Making sense of complex, high quantity, and sometimes contradictory information to effectively solve problems.
  2. Persuades: Using compelling arguments to gain support and commitment of others.
  3. Plans and Aligns: Planning and prioritizing work to meet commitment aligned with organizational goals.
  4. Resourcefulness: Securing and deploying resources effectively and efficiently.
  5. Drive Results: Consistently achieving result, even under tough circumstances.

Cultural Competencies:

Advanced Values:

  1. People
    • Collaborates: Building partnerships and working collaboratively with others to meet shared objectives
  2. Heart
    • Patient Focus: Building strong patient relationships and delivering patient centric solutions
  3. Service
    • Instills Trust: Gaining the confidence and trust of others through honesty, integrity, and authenticity
  4. Excellence
    • Cultivates Innovation: Creating new and better ways for the organization to be successful

Behaviors:

  1. Being Resilient:
    • Rebounding from setback and adversity when facing difficult situations
  2. Self-Development:
    • Actively seeking new ways to grow and be challenged using both formal and informal development challenges
  3. Optimizes Work Processes:
    • Knowing the most effective and efficient processes to get things done, with a focus on continuous improvement
  4. Professional Communication:
    • Developing and delivering multi-mode communications that convey a clear understanding of the unique needs of different audiences, while maintaining a professional appearance and tone

QUALIFICATIONS

Basic Qualifications:

Education:

  • High School Diploma or GED

Previous, Job Relevant Work Experience:

  • 4+ years of experience in healthcare-related field or setting
  • Working knowledge of Medicare, Medicaid, and other contract payers (HMO, PPO)

Preferred Qualifications:

Previous, Job Relevant Work Experience:

  • 5+ years of experience in healthcare related setting
  • Previous experience in Clinic, ASC or Hospital setting
  • Working knowledge of E-clinical Works
  • Working knowledge of payor portals and Availity
  • Working knowledge of Clearinghouse system

Credentials/Licensures (Nice to have)

  • Certified Patient Account Representative (CPAR)

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