Patient Account Representative - Medical Billing, Surgery Center

Hancock Regional Hospital • Greenfield, IN

135d

About The Position

The patient account representative is responsible for managing all aspects of accounts receivables to ensure maximum/timely reimbursement for services performed. 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, and place calls to the payers to collect and assist in maintaining Network A/R days. Follow up may be performed by way of payer websites when appropriate.

Requirements

• High School Diploma or GED required.
• 2+ years of experience in revenue cycle healthcare within a medium to large health care system.
• Knowledgeable regarding payer billing guidelines and hospital and physician claim form billing requirements.
• Medical billing experience is required.
• CPR (Cardio-Pulmonary Resuscitation) certification.

Responsibilities

• Performs daily billing processes including 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 impact 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.
• 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.

What This Job Offers

• Industry: Ambulatory Health Care Services
• Education Level: High school or GED
• Number of Employees: 501-1,000 employees