Patient Account Coordinator

23 hours ago


Carrollton, Texas, United States Family Medicine Associates of Texas Full time
Job Summary

Family Medicine Associates of Texas seeks a skilled Patient Account Representative to join our team. This role encompasses all aspects of insurance claims processing, patient billing, patient relations, and accounts receivable to maintain standard benchmarks for billing and for Family Practice groups.

Key Responsibilities:

  • Understanding of managed care issues and complexities.
  • Review approved claims for billing accuracy.
  • Accurately post payments and adjustments.
  • Work A/R for specific networks, following up on claims with insurance carriers and documenting in the computer.
  • Use of a tickler system for timely follow-up of Outlook, correspondence with insurance companies and patients.
  • Ability to process reports for the end of day close and scan.
  • Knowledge of insurance denials and writing appropriate appeals.
  • Understand policies to set up payment plans for patient balances.
  • Report delinquent accounts to Supervisor for Physician approval.
  • Prepare delinquent accounts for firing prior to being sent to outside collection agency.
  • Write letters to the Texas Department of Insurance as necessary.
  • Extensive knowledge of CPT and ICD-10 codes, including timing of new codes and deletion of old codes.
  • Accurate entry and timely deletion of pop-up memos on patient and/or family accounts.
  • Analyze and utilize a "Problem List" for specific networks and meet with Provider Representative and/or IPA as necessary to resolve problems.
  • Process accounts for patient and/or insurance company refunds when applicable.
  • Knowledge of correct fee schedule for reimbursement of specific networks.
  • Meet with Business Office Manager as needed regarding networks and status of accounts.
  • Knowledge of insurance verification process and how to enter information into the system.
  • Knowledge of the Athena One EMR system.

Requirements:

  • Understanding of managed care issues and complexities.
  • Knowledge of CPT and ICD-10 codes.
  • Ability to process reports for the end of day close and scan.
  • Knowledge of insurance denials and writing appropriate appeals.
  • Understanding of policies to set up payment plans for patient balances.


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