Patient Account Representative

13 hours ago


La Vergne, Tennessee, United States Williamson Health Full time
Job Title: Patient Account Representative

Join Williamson Health as a Patient Account Representative and play a vital role in ensuring the financial well-being of our patients. As a key member of our team, you will be responsible for following up on accounts for services rendered at our hospital, maximizing the full payment potential of each claim from commercial, government, and auto liability carriers in a timely and accurate manner.

Key Responsibilities:
  • Follow up on accounts for services rendered at Williamson Health
  • Maximize the full payment potential of each claim from commercial, government, and auto liability carriers
  • Work with patients and insurance carriers to resolve billing and account balance issues
  • Collaborate with hospital departments to ensure proper charges, adjustments, and codes are processed by carriers and patients' balances are correct
  • Fill in for Commercial/Government Biller as needed
Requirements:
  • High school graduate or equivalent
  • Hospital and physician billing experience
  • PC and calculator experience
  • Good communication skills to discuss account financials with insurance carriers and patients
  • Prior experience in a hospital setting or related area
Preferred Qualifications:
  • Working knowledge of DDE and EServices
  • Home Health, Hospice, and SNF follow-up experience
Equipment and Skills Training:
  • Meditech System
  • SSI Electronic Billing System
  • SSI Electronic System for RA Print
  • FIND IT
  • Experian
  • Blue Cross
  • DDE System
  • Payer Websites
  • Excel
  • Word
  • PC
  • Printers
  • Fax
  • Copier
Physical Environment:

Business Office

Physical Effort:

Requires sitting for prolonged periods of time, viewing the computer screen, and using repetitive motions. Must have a clear, understandable telephone voice.

Performance Standards:
  • Utilizes SSI Electronic software to accurately process all Medicare and Medicare Managed Care accounts assigned by system daily
  • Processes Medicare and Medicare Managed Care paper claims when necessary
  • Compares SSI electronic claim against Meditech claim when dealing with Medicare questions regarding claim submitted and works on resolving discrepancies to prevent denial
  • Utilizes Medicare's Direct Data Entry (DDE) system to access information such as claim status inquiry, eligibility, daily Medicare check amounts, etc.
  • Analyzes Medicare EOBs and remittances for secondary insurance filing and to determine appropriate patient liability or secondary payer amount
  • Utilizes Outlook to communicate denials with various departments as well as Passport and Medicare Managed Care websites for information necessary for account processing
  • Completes review of assigned Medicare accounts utilizing ATB (current account balance) reports and/or Collector Desktop list as needed for account processing in a time frame that is consistent with peers
  • Converses and documents all discussions with Medicare and Medicare Managed Care payers regarding unpaid claims
  • Answers patient calls regarding billing and account balances for all Medicare/MCR Managed Care accounts
  • Re-queues Medicare/MCR Managed Care claim forms and itemized bills as needed after audit corrections have been completed
  • Handles and prioritizes multiple tasks
  • Completes any other job duties assigned by the department Director or Supervisor(s)


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