Patient Account Representative - Billing

Copley Hospital • Morrisville, VT

92d

About The Position

Copley Hospital, located in Morrisville/Stowe VT, is in search of a Patient Account Representative - Biller to join our team! The Patient Account Representative functions in a team environment to appropriately resolve patient accounts. The responsibilities encompass all financial aspects of the patient encounter from initial billing through final resolution of the account, while maintaining excellent customer service. The Representative specializing in insurance billing & collections is responsible for accurate and timely billing and collections of insurance claims, conducting all activities in compliance with all applicable State and Federal laws, regulations, and policies governing the provision of health care. This is a Full-Time position (PT available). Copley Hospital has a variety of shifts available across Full-Time, Part-Time, and Temporary needs. Please consider applying to discuss how your availability may align. Compensation: Negotiable. An offer of employment may vary based on factors such as experience, education, skill, internal equity, and market data.

Requirements

• High School Diploma or equivalent.
• Medical Terminology Course desired.
• Desired health care insurance billing experience, or experience in a hospital admitting, registration, business office, or coding function.

Responsibilities

• Extends payment arrangement offers to guarantors in accordance with department policies and procedures.
• Submits coded, complete, timely, and clean claims to assigned carrier(s), either electronically or on paper, on a daily basis, with accuracy and in accordance with the policies and procedures of the PFS department and the specific policies and billing guidelines of the insurance carrier.
• Reviews late charges on a daily basis and takes appropriate action to submit corrected claims, in accordance with department policies and procedures.
• Reconciles claim submission index in CPSI (EBOS) to ensure that electronic claims submitted are cleared through the clearinghouse and accepted by the carrier.
• Takes appropriate and timely action on all correspondence related to assigned carrier(s) in accordance with the policies and procedures of the PFS department and the specific policies and billing guidelines of the insurance carrier.
• Reviews posted remittance advices from assigned insurance carrier(s) within the timeframe established by department policies and procedures, appropriately following up on and resolving any rejections or other non-payments.
• Follows up on outstanding insurance claims on a daily basis using the Billed but Unpaid report, as well as any priority listing of unpaid claims as assigned by the Billing & Collections Manager and or Director of Revenue Cycle.
• Responds to internal and external account inquiries in a timely manner and with the utmost professionalism and courtesy.
• Timely management of documentation in the office in accordance with department policies and procedures (ie. filing, scanning, etc.), and in compliance with privacy requirements of HIPAA.
• Reviews credit balance accounts at least weekly to identify potential overpayments and submit timely requests for recoupment or refund.
• Works collaboratively with others in the organization to appeal non-payments or denials of claims for services, as appropriate.
• Manages insurance claim lines, collect codes, patient profile information, and electronic files in patient accounts in accordance with the policies and procedures of the PFS department and the Patient Access department.
• Enters appropriate, succinct, and professional notes in patient accounts in a timely manner for ALL communications with, or regarding, patients, guarantors, or insurance carriers.
• Performs all job duties with the utmost integrity and in compliance with the requirements of the assigned insurance carrier(s)’s policies and all applicable State and Federal laws, regulations, and policies governing the provision of health care.
• Keeps the Billing & Collections Manager and or Director of Revenue Cycle informed of issues encountered in common billing edits, rejections or other non-payments, patient complaints, and any other major issues impacting customer service, cash flow, productivity, revenue integrity, or compliance.
• Other duties as necessary upon the direction of the Billing & Collections Manager and or Director of Revenue Cycle.
• Keeps self informed of billing policies and requirements of assigned insurance carrier(s) by regularly monitoring list-servs, carrier websites, maintaining open lines of communication with provider representatives, researching problem claims, and other means of staying informed.

What This Job Offers

• Job Type: Part-time
• Education Level: High school or GED
• Number of Employees: 101-250 employees