Accounts Representative

CASS REGIONAL MEDICAL CENTER•Harrisonville, MO

10d•Onsite

About The Position

The Accounts Representative is responsible for ensuring that all billing and collection is done in a timely manner and in accordance with the provider insurance contract. This role involves making recommendations regarding policies associated with the job's purpose and essential responsibilities, and involves routine decision making regarding accurate billing setup, knowledge of electronic billing edits, accurate claim form setup, UB billing guidelines, understanding of ICD-10 and CPT codes guidelines, and billing and reimbursement guidelines for services billed per payer. The position also involves providing input into policies associated with the job's purpose and essential responsibilities. There are no unusual working conditions associated with this role.

Requirements

High school education.
Knowledge of state and federal rules and regulations, to include Critical Access Hospital; billing standards; CPT and ICD-10 coding guidelines; medical computer software programs; and insurance policies and procedures, 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 is preferred.
CRCR or comparable certification preferred.

Responsibilities

Follow-up on all commercial insurance, MC MCD (80% of time)
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) (15% of time).
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 posts 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. 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.
Actively participate in Business Office Operations and all other duties as assigned. (5%)
Willingly take on other duties as assigned.
Use available resources efficiently and effectively (e.g., 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.