Patient Account Representative (239)

Hancock Regional Hospital - Greenfield, IN

Greenfield, IN

Ambulatory Health Care Services

About the position

The patient account representative is responsible for managing all aspects of accounts receivables to ensure maximum/timely reimbursement for services performed. The patient account role will be responsible for keeping current on all payer specific regulations and procedures and will provide written summaries of findings and recommendations. This position is customer focused with emphasis on accounts receivable management. The patient account representative is required to follow established guidelines, take action to recover delinquent accounts with the payers. Place calls to the payers to collect and assist in maintaining Network A/R days. Follow up maybe performed by way of payer websites when appropriate.

Responsibilities

• Performs daily billing processes including but are not limited to pre-billing reports/workqueues, claim corrections, and Medicare FISS system claim corrections.
• Monitors the billing and follow up holds at all sources, ensures timely resolution and is responsible for keeping assigned tasks current.
• Documents all actions taken on accounts in the system account notes to ensure all prior actions are noted and understandable by others.
• Maintains knowledge of applicable rules, regulations, policies, laws and guidelines that would impacts Government and NonGovernment billing and follow-up.
• Complies with applicable state/federal laws and the program requirements of accreditation agencies and federal, state and government health plans.
• Informs leadership of changes in payer requirements.
• Exercises independent judgment to report repetitive rejections so that corrective actions can occur.
• Treats patients and their families along with internal customers with respect and dignity.
• Ensures confidentiality of patient records.
• Responds to customer concerns in a timely and professional manner.
• Meets productivity standards designated by the department.
• Meets QA standards designated by the department.
• Assists leadership with special projects.
• Performs other duties as assigned by the Supervisor.
• Adheres to all network and departmental procedures and policies.
• Adheres to and supports the network PRIIDE values and Standards of Behavior guidelines.
• Completes annual educational requirements.
• Maintains A/R to meet Network set goals.
• Follows billing and collection procedures as outlined in policies and provides payers with the appropriate and necessary information to adjudicate claim.
• Participates in monthly conference calls with specific payers.
• Follows appropriate steps to resolve insurance correspondence scanned into mail queues.
• Follows appropriate steps to resolve denials within specified timeframe.

Requirements

• Ability to analyze data involving many variables and convert to actionable information.
• Ability to be detail oriented.
• Ability to continuously develop and improve ones self.
• Ability to extract information from medical records to support claim appeals.
• Ability to independently manage time and priorities.
• Ability to independently resolve problems.
• Ability to use customer service skills to provide an exceptional experience.
• Ability to utilize Microsoft Office Suite.
• CPT and ICD-10 coding; knowledge of commercial and governmental rules.
• Knowledge of documentation requirements, coding guidelines as well as government and commercial payer rule and edits.
• Ability to communicate effectively both orally and in writing.