About The Position

This position is for a Patient Account Representative Lead in Pre-visit Services/Authorizations at OU Health. The role involves leadership responsibilities and acting as a subject-matter expert for a small team processing authorizations and referrals. The ideal candidate will have leadership experience and a minimum of 3 years in authorizations. Candidates must reside and work full-time in OK before their first day of employment. The position is Monday-Friday, Days, with on-site requirements as needed, at least monthly. OU Health offers competitive wages and a total rewards package, including PTO, 401(k), medical and dental plans.

Requirements

  • High School Diploma or GED.
  • At least 5 years of experience in Medical Billing, Medical Collections, Medical Billing Systems (IDX or other billing system) required.
  • Proven ability to manage a team of professionals and lead a departmental function
  • Excellent verbal and written communication skills
  • Proficient with the use of Microsoft Office tools
  • Candidates must reside and work full-time in OK before their first day of employment.

Nice To Haves

  • Leadership experience
  • Minimum of 3 years in authorizations

Responsibilities

  • Patient scheduling
  • Patient registration
  • Review patient admitting records and extracts relevant information
  • Records patient identification and demographic information in the computerized billing system
  • Contacts agency representatives to verify type and extent of coverage.
  • Charge entry
  • Performs preliminary review of source documents to determine that sufficient data are present for processing
  • Using alphanumeric keyboard, transcribes and/or verifies data from source documents to the medium used for entering data into the computer
  • Batch charges
  • Generate cash totals
  • Enter charges
  • Balances batches by comparing batch proofs to source documents and hash totals
  • Billing
  • Works with all areas of the organization in getting any necessary or requested documentation for patients, insurance carriers or other areas.
  • May interact with hospital patient accounting or records personnel to obtain patient demographic or other billing information
  • Operates hospital information system terminal to obtain patient demographic information, patient insurance information and status of approvals or denials
  • Completes processing of all inpatient and outpatient documents received on a daily basis
  • Assists in resolving department problems with IDX billing
  • Maintains records of charges, payments, third party charges, etc.
  • Collection
  • Answers patient’s questions regarding statements, agency coverage, etc.
  • Handles correspondence regarding collection activity and records results
  • Identify patient accounts for collection action when accounts become delinquent or when unable to contact patient or responsible party
  • May receive patient payments and/or issue payment receipts
  • Coding
  • Record CPT codes on billing forms
  • Record ICD-9 codes on billing forms
  • Follow-up
  • Initiates contact with patients and/or third party carriers if there is a delay in responding to statements or claims
  • May process incoming and outgoing mail
  • May receive incoming telephone calls and resolve issues communicated
  • Records results of mail and telephone contacts on the computer billing system
  • Contacts insurance carriers regarding non-payment and/or improper payment of claims
  • Reviews denials
  • Interfaces with patients, physicians, and others regarding professional billing operations and funds
  • Payment posting
  • Post receipts to proper patient accounts
  • Post denials
  • Compare batch proofs and source documents for accuracy
  • Reporting
  • Assists in reviewing and balancing IDX transaction reports for administration
  • Reconciles daily IDX receivables reports
  • Prepares billing statements from statistical data
  • Credit balance resolution
  • Review daily billing and accounts receivable credit balance reports
  • Prepare daily refund check requests
  • Prepare other daily credit balances other than refunds
  • Post refund checks to patient accounts
  • Mail refund checks with supporting documentation
  • Personnel Supervision
  • Leads and trains employees.
  • Performs other duties as assigned.

Benefits

  • PTO
  • 401(k)
  • medical and dental plans
  • total benefits and compensation package
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