Patient Account Representative: Insurance Claim Follow-Up Specialist

1 week ago


Tulsa, Oklahoma, United States Saint Francis Health System Full time
Job Summary:

We are seeking a highly organized and detail-oriented Patient Account Representative to join our team at Saint Francis Health System. As a Patient Account Representative, you will be responsible for ensuring that patient accounts are processed in a timely and accurate manner, and that any issues causing payment delay are identified and resolved.

Key Responsibilities:
  • Monitor, research, and update patient accounts to resolve balances and maximize reimbursement.
  • Answer patient, insurance, and client calls and respond to correspondence in a timely manner to ensure resolution of account balances.
  • Act as liaison between Patient Accounts and physician offices, insurance carriers, clinical areas, and other third-party payers to assist with document requests, eligibility issues, contractual payment accuracy, and claim submission promptness.
  • Use appropriate guidelines to evaluate and adjust accounts based on patient/account status.
  • Review past due self-pay balances for assignment to outside collection sources, financial assistance, or payment plan opportunities.
  • Monitor daily electronic claims transmission, research, and resolve electronic claim rejections, and ensure accurate postings of contractual payments and rejection codes.
  • Review insurance reimbursement to verify compliance with fee schedules, appeal underpayments and denials using correct tools/resources, and reconcile payments received and posted daily with financial accounting.
Requirements:
  • High School Diploma or GED.
  • 2 years of relevant experience.
  • Basic healthcare and insurance terminology.
  • High level of timeliness and accuracy.
  • Basic computer knowledge and skills.
  • Ability to navigate insurance websites to access patient, eligibility, and payment information.
  • Good communication skills - written and verbal.
  • Understanding of a professional business environment.
  • Basic knowledge of medical billing and insurance follow-up activity.
Working Relationships:

This position works directly with patients and/or customers, internal customers via telephone or face-to-face interaction, other healthcare professionals and staff, and external customers via telephone or face-to-face interaction.



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