Insurance Account Representative

YELLOWSTONE SURGERY CENTER•Billings, MT

15d•$19 - $23

About The Position

Responsible for accounts receivable, insurance verification and pre-certification, insurance follow-up, contacting patients/responsible parties for insurance questions or coverage concerns, and other accounting and reporting functions as assigned.

Requirements

Minimum High School diploma or equivalent
Minimum of two years related experience with patient accounts, billing/collections experience, preferably in a health care setting

Responsibilities

Obtains insurance information and demographics to verify the patient’s insurance eligibility and benefit coverage before admission to the facility
Contacts patients with out-of-network insurance and/or limited benefit policies before admission to the facility to discuss options for payment
Contact insurance companies for appropriate pre-authorization/pre-determination on all necessary pain procedures before the patient’s admission to the facility
Ensures that pre-authorization has been obtained from the physician's offices for all surgical procedures.
Communicates with patients before their scheduled procedure, if an insurance company has denied pre-authorization or if pre-authorization was not able to be obtained, and ensures appropriate paperwork is completed and signed by the patient
Receives and responds to all patient and insurance company inquiries concerning billing, deductibles, co-insurance, copayments, etc.
Ensures that all procedures that are scheduled at the facility are payable and that the reimbursement is greater than the costs associated with performing the procedure(s). Reviewing the cost vs. reimbursement with the Patient Account Manager
Verifies patient’s insurance cards that are scanned at check-in daily
Processes all initial and secondary insurance billing to the appropriate payers promptly after charges are posted to a patient’s account
Actively follow up with all outstanding insurance claims for timely payment as per the facility's contracts with the payers
Prepares adjustment and insurance refund sheets every month for review and approval by the Patient Account Manager
Ensures that all appropriate documentation is entered into the SIS operating system and Papervision for future reference
Assists the Patient Account Manager with updating business office manuals as necessary
Works closely with all other positions in the business office, the Coders, Patient Access Specialists, physicians, and their offices
Adheres to all company policies and procedures
Participates in the Surgery Center’s Quality Improvement Program activities, including identification of opportunities for cost reductions and efficiencies
Attends all center meetings and educational opportunities. Attends continuing education opportunities when available
Maintains patient confidentiality at all times
Prioritizes job responsibilities and demonstrates flexibility to meet the needs of the Surgery Center and to facilitate optimum quality of patient care
Performs efficiently in emergencies
Other duties as assigned by the Patient Account Manager