Patient Account Representative - OP

Emory Healthcare•Atlanta, GA

About The Position

Overview Be inspired. Be valued. Belong. At Emory Healthcare At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide: Comprehensive health benefits that start day 1 Student Loan Repayment Assistance & Reimbursement Programs Family-focused benefits Wellness incentives Ongoing mentorship, development, leadership programs And more Description RESPONSIBILTIES: As part of a team or works independently to resolve complex patient account issues. Collects and follows up on all accounts assigned prior to, during, or after admission and discharge. Serves as patient advocate during the cycle of the account. Responsible for accurate posting of insurance company and patient payments, including accurate contractual adjustments and denials. Responsible for complete and accurate resolution of credit balance invoices through telephone, mail, and research efforts. Maintains and is familiar with UB and HCFA Billing Manuals. Coordinates classification for bad debt and charity. Maintains knowledge and is familiar with Patient Accounting system. Independently assesses Claim Edit, Transaction Editing System, Clearinghouse, or other applicable billing edit messages to resolve any issues preventing release of physician or hospital claims from Emory's systems. This includes maintaining up-to-date knowledge of insurance rules, referral requirements, payor websites, eligibility portals, and Emorys verification systems. Must demonstrate a working knowledge of CPT, ICD-10, modifiers, coding and documentation guidelines.

Requirements

High school diploma or equivalent.
Two (2) years of collections, billing, and/or registration experience in a healthcare or insurance setting OR any combination of equivalent education and experience.
Typing skills with a minimum of 35 wpm and good communication skills.

Nice To Haves

Certified Patient Accounts Representative (CPAR) and/or Certified Patient Financial Counselor (CPFC) preferred for positions in the hospital setting.

Responsibilities

As part of a team or works independently to resolve complex patient account issues.
Collects and follows up on all accounts assigned prior to, during, or after admission and discharge.
Serves as patient advocate during the cycle of the account.
Responsible for accurate posting of insurance company and patient payments, including accurate contractual adjustments and denials.
Responsible for complete and accurate resolution of credit balance invoices through telephone, mail, and research efforts.
Maintains and is familiar with UB and HCFA Billing Manuals.
Coordinates classification for bad debt and charity. Maintains knowledge and is familiar with Patient Accounting system.
Independently assesses Claim Edit, Transaction Editing System, Clearinghouse, or other applicable billing edit messages to resolve any issues preventing release of physician or hospital claims from Emory's systems.
This includes maintaining up-to-date knowledge of insurance rules, referral requirements, payor websites, eligibility portals, and Emorys verification systems.
Must demonstrate a working knowledge of CPT, ICD-10, modifiers, coding and documentation guidelines.