Athena Patient Account Representative

Sullivan County Community Hospital • Sullivan, IN

10d • Onsite

About The Position

This role involves reviewing, identifying, and correcting claims issues, ensuring timely submission of clean claims, and managing outstanding accounts receivable. The position requires understanding third-party billing, Medicare/Medicaid guidelines, and payor contracts. The representative will also handle claim denials, follow up with insurance companies, and provide phone support.

Requirements

• High school graduate or equivalent
• Possesses knowledge of business office operations
• Understands third party billing requirements
• Understands Medicare/Medicaid inpatient and outpatient billing
• Strives for customer satisfaction when responding to all patient/customer inquires (internal customers)
• Experience using office equipment
• Adapts professionally to changes in procedures and/or workload
• Possesses excellent written and oral communication skills
• Works independently with little supervision
• Maintains concentration
• Remains committed to a “cross training” philosophy for all assigned tasks

Nice To Haves

• Athena experience preferred

Responsibilities

• Reviews, identifies, and corrects claims issues identified in inhouse hold and the claim scrubbing holds
• Sends clean, timely claims out on first billing
• Works reconciliation desktops to ensure upfront rejection of claims are processed and resubmitted to correct payer
• Reviews assigned outstanding accounts receivable by using ATB, queues, and payment reports
• Submits timely and accurate adjustments documenting activity in account
• Understands and manages denials, submitting timely disputes and appeals
• Follows up with insurance companies to ensure claims are processed and paid correctly according to contract
• Understands payor contracts and billing guidelines. revenue codes, cpt codes, modifiers, and payor-specific guidelines
• Investigates and reports claims denial trends with payer documentation for departments to review and establish action plan
• Provides back-up phone support to billing lines daily

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED