Patient Account Rep. - Patient Accounting

Phoebe Putney Health System•Albany, GA

1d•Onsite

About The Position

Processes and monitors billing and follow up of claims submitted for payment to insurance payors, governmental payors and state agencies. Description: Essential Functions ATTENTION TO BILLING DETAIL - PATIENT ACCOUNT REP: Prepares billing and follow ups on claims in a timely manner. Performs accurate and timely billing and account reviews ensuring that accurate information has been reviewed before sending to applicable payors or state agencies. Conducts account review ensuring accurate billing information, enters and revises information as needed prior to claim being submitted. Prepares adjustment bills, rebills, reprints claims and/or other source documents. Processes failed claims in biller work file according to carrier specific requirements. Coordinates with concurrent review precert nurse and/or admitting staff on precertification requirements. Prepares daily productivity reports. CUSTOMER SERVICE - PATIENT CLAIM ISSUES: Serves as liaison between patient, employer, and carrier in resolving claim issues. Communicates with patient, employer and carrier regarding claim status. Processes patient inquiry requests within 24 hours. Assists with Customer Service coverage duties as need arises. KNOWLEDGE OF BUSINESS OFFICE DEPARTMENT GUIDELINES AND PROGRAMS: Demonstrates knowledge of ever changing payer guidelines and regulations, programs and machines used. Demonstrates mastery of computer programs and office machines used. Strong Performance includes mastery of the following skills, tasks and behaviors. Creates and maintains via account notes, all correspondence, whether written or verbal, including discussion with carriers, patients or guarantors. Scans correspondence into the ChartMaxx system. Submits Medicare Credit Balance Report quarterly, necessary to ensure that Phoebe Putney Memorial Hospital remains compliant with CMS rules and regulation. Attends seminars and education relating to Medicare, Medicaid and Commercial. Attends and participates in hospital and departmental staff meetings. DOCUMENTATION: Documents and submits required information and data in a timely fashion. Clearly and accurately documents designated processes, policies, products, service offerings, etc. Ensures that documentation is tailored to expected readers / users. Uses correct terminology. Conforms to required style and format.

Requirements

High School Diploma or GED (Required)
2 - 3 years a structured business environment (Required)
CPAR certification or must be obtained within two years of employment
Adheres to the hospital and departmental attendance and punctuality guidelines
Performs all job responsibilities in alignment with the core values, mission and vision of the organization
Performs other duties as required and completes all job functions as per departmental policies and procedures
Maintains current knowledge in present areas of responsibility (i.e., self education, attends ongoing educational programs)
Attends staff meetings and completes mandatory in-services and requirements and competency evaluations on time.
25% Demonstrates competency at all levels in providing care to all patients based on age, sex, weight, and demonstrated needs. For nonclinical areas, has attended training and demonstrates usage of age- specific customer service skills.
Have near normal hearing - Hear alarms, telephone, tape recorder, normal speaking voice
Have near normal vision - Clarity of vision (both near and far), ability to distinguish colors,
Have good - manual dexterity and eye-hand-foot coordination.
Ability to perform - repetitive tasks and motion.

Nice To Haves

2 - 3 years hospital, Physician office or insurance environment (Preferred)

Responsibilities

Prepares billing and follow ups on claims in a timely manner.
Performs accurate and timely billing and account reviews ensuring that accurate information has been reviewed before sending to applicable payors or state agencies.
Conducts account review ensuring accurate billing information, enters and revises information as needed prior to claim being submitted.
Prepares adjustment bills, rebills, reprints claims and/or other source documents.
Processes failed claims in biller work file according to carrier specific requirements.
Coordinates with concurrent review precert nurse and/or admitting staff on precertification requirements.
Prepares daily productivity reports.
Serves as liaison between patient, employer, and carrier in resolving claim issues.
Communicates with patient, employer and carrier regarding claim status.
Processes patient inquiry requests within 24 hours.
Assists with Customer Service coverage duties as need arises.
Demonstrates knowledge of ever changing payer guidelines and regulations, programs and machines used.
Demonstrates mastery of computer programs and office machines used.
Creates and maintains via account notes, all correspondence, whether written or verbal, including discussion with carriers, patients or guarantors.
Scans correspondence into the ChartMaxx system.
Submits Medicare Credit Balance Report quarterly, necessary to ensure that Phoebe Putney Memorial Hospital remains compliant with CMS rules and regulation.
Attends seminars and education relating to Medicare, Medicaid and Commercial.
Attends and participates in hospital and departmental staff meetings.
Documents and submits required information and data in a timely fashion.
Clearly and accurately documents designated processes, policies, products, service offerings, etc.
Ensures that documentation is tailored to expected readers / users.
Uses correct terminology.
Conforms to required style and format.