Patient Account Representative I

McLaren Health Care•Shelby Township, MI

110d•Remote

About The Position

Under general direction, the Patient Account Representative I completes tasks associated with specific assignments in billing, follow-up, customer service, collections, cash posting, or other areas as assigned by CBO Management. The representative is expected to meet the quality and productivity standards for the assigned responsibilities. The role may involve billing hospital and physician claims for inpatient and outpatient services, maintaining patient accounts in billing and claims-editing systems, responding to patient and commercial inquiries, contacting insurers, resolving claim issues, and following up with third-party payors to obtain payment or resolve accounts. Responsibilities vary according to assignment.

Requirements

High school diploma or GED.
Working knowledge of CPT, HCPCS, and ICD-1.
One year of experience in hospital financial or patient services.

Nice To Haves

Associate degree in health care, finance, or a related area.
Equivalent combination of education and relevant experience.

Responsibilities

Respond promptly, professionally, and courteously to customer needs.
Cooperate and communicate effectively with McLaren Health Care team members.
Contribute to continuous quality improvement efforts.
Complete tasks accurately and on time.
Organize time and prioritize effectively.
Practice cost-effective measures.
Maintain confidentiality regarding patients, the hospital, the department, and human resources.
Bill hospital and physician claims for inpatient and outpatient hospital and clinic services within insurance filing limits.
Interpret third-party requirements and bill facility and physician services within filing requirements.
Maintain patient accounts in billing and claims-editing systems.
Respond promptly to patient and commercial inquiries by phone or written correspondence regarding patient accounts.
Contact insurance companies regarding unreleased, unprocessed, or outstanding bills.
As assigned, develop relationships and work with respective vendors in a timely and professional manner.
Work with other departments and insurance companies to resolve bill and claim edits.
Notify the Analyst of edits that need to be built and the Denials Representative of denial trends.
Coordinate and monitor billing activities relating to bone marrow transplant package pricing.
Follow up with third-party payors on inpatient and outpatient accounts to obtain payment or resolution within insurance filing limits.
Follow up monthly on the Age Trial Balance Report.
Resolve issues involving third-party payor and self-pay claims.