Outpatient Patient Accounts Rep.

Sturdy Memorial Hospital•Attleboro, MA

2d•Onsite

About The Position

Perform third party billing functions within established third party regulations and requirements. Responsible for all aspects of hospital/professional claim review and resolution. Attain and maintain knowledge of billing/accounts receivable data processing procedures and systems for the purpose of performing daily routine data entry that is required for the billing process. Under the direct supervision of the Patient Accounts Supervisor and within established Hospital and departmental policies and procedures performs billing functions in order to bring accounts to resolution within a reasonable time frame. Use all resources, including guidebooks, payer websites, etc., to resolve any claim issues before reaching out to management. Consistently treats patients, colleagues and visitors with the dignity and respect, while being sensitive to the differing needs of all age groups, backgrounds, characteristics and cultures. Must have the ability to the perform essential functions of the position, including required work hours, locations and physical demands, without posing a direct threat to the health and safety of themselves or other individuals in the work place, and with or without reasonable accommodation.

Requirements

High School Diploma or equivalent
Minimum of 2 years of third party hospital/physician billing experience
Excellent communication skills
Demonstrates computer literacy appropriately within the Cerner and SSI systems and Third Party Web Sites
Ability to resolve problems with limited supervision.
Focuses on quality improvements while problem solving

Nice To Haves

Ability to multi-task
Work well in a team environment
Medicare billing experience is preferred.

Responsibilities

Perform third party billing functions within established third party regulations and requirements.
Responsible for all aspects of hospital/professional claim review and resolution.
Work assigned work queues daily/weekly to resolve claim denials in Cerner to ensure correct reimbursement and to avoid timely filing issues.
Examine incoming correspondence and review rejections to determine if further follow up is necessary.
When trying to resolve claim denials or issues, identify if another department needs to be contacted to obtain correct charge/coding information.
Processes third party refunds.
Research and resolve misapplied monies that have been posted to accounts incorrectly.
Monitor follow up reports.
Identify repeat claim errors by payer.
Take appropriate action on delinquent accounts.
Reports ongoing billing problems to the Patient Accounts Supervisor so a solution may be found and implemented to avoid further problems.