Accounts Representative

CASS REGIONAL MEDICAL CENTER•Harrisonville, MO

1d•Onsite

About The Position

Primary Purpose: To ensure that all billing and collection is done in a timely manner and in accordance with the provider insurance contract. Formally responsible for making recommendations regarding policies associated with the job’s purpose and essential responsibilities. Routine Decision Making: Accurate billing setup, knowledge of electronic billing edits. Accurate claim form set up. UB billing guidelines. Understanding of ICD-10 and CPT codes guidelines. Billing and reimbursement guidelines for services billed per payer. Formally responsible for providing input into policies associated with the job’s purpose and essential responsibilities. Unusual Working Conditions: None.

Requirements

High school education.
Knowledge of state and federal rules and regulations, to include Critical Access Hospital.
Knowledge of billing standards.
Knowledge of CPT and ICD-10 coding guidelines.
Knowledge of medical computer software programs.
Knowledge of insurance policies and procedures.
Knowledge of Washington Publishing Company denial and remittance codes.
Knowledge of CCI and NCCI edits.
Understanding of accurate use of modifiers.
Proficiency in Excel.
Application and maintenance computer skills.
Verbal and written communication skills, to include writing appeals.
Ability to prioritize and work independently.
Problem solving skills.

Nice To Haves

Previous experience utilizing ICD-10 and CPT coding.
CRCR or comparable certification.

Responsibilities

Follow-up on all commercial insurance, MC MCD & Liens Accounts
Review all accounts for accuracy of billing guidelines to include CPT, ICD 10, and modifier usage.
Understand priority of accounts by dollar and age meeting productivity and quality standards and to work all accounts within 30 days of denial or billed date.
Review denials and report as trending issues to the Billing Coordinator.
Work unapplied credits monthly.
Contact IS for any computer issues immediately.
Handle all aspects of accounts resolution in order to resolve any issue with patient/account (i.e., insurance issues, rebilling claims, credit balances).
Provide Excellent Customer service to all individuals representing the Cass Regional Medical Center Values.
Act as back up to Cashier or PBX operator as needed.
Act as a financial advocate for the patient in understanding and reconciling statements and or daily charges.
Accept payments and post accurately.
Document all conversations completely and timely.
Accept and process Financial Assistance and Patient Concerns according to policy.
Answer phones cheerfully by 3rd ring, identifying yourself and Cass Regional.
Ensure phone line is always open and all voicemails are answered by the end of the day.
Accurate application of Financial Class, transaction codes, payer class etc.
Willingly take on other duties as assigned.
Use available resources efficiently and effectively (I.E., Manuals, Internet Payer Websites, etc.).
Participate in process improvement for business office procedures and actively follow all policy and procedures of the department.
Actively participate and follow all department policy and procedures.