Patient Account Representative

UMC Health System•Richmond, KY

3d•Onsite

About The Position

Ability to communicate both verbally and in writing, mainframe computer skills, basic accounting and detailed clerical skills and good customer relation skills. Manage the in network and out of network accounts according to third party payer rules, and to comply with MTALA rules and regulation. Have knowledge, and an understanding of medical and third party payer terminology.

Requirements

High school graduate or equivalent required
Ability to communicate both verbally and in writing
Computer skills
Basic accounting and detailed clerical skills
Highly technical and problem-solving skills
Ability to handle change within the workplace
Mainframe computer skills
Good customer relation skills
Knowledge, and an understanding of medical and third party payer terminology
Manage the in network and out of network accounts according to third party payer rules, and to comply with MTALA rules and regulation.

Nice To Haves

Some college preferred

Responsibilities

Manage and have knowledge of all contracts particular to your desk.
Determine if correct reimbursement has been submitted by the payer and/or if credit is due to incorrect proration.
Use the correct transaction codes when adjustments are required on a visit.
All mail received should be worked within 48 hours from received stamped date.
Inform Supervisor or Director of large dollar adjustments, at least weekly, utilizing the high dollar adjustment spreadsheet. Documentation is required either in NB or as a comment on the transaction adjustment.
Work as a team member to ensure departmental cash collections goals are met or exceeded; this includes proper handling of credit balances.
Work all hold bills assigned to you in a timely manner.
Inform your Supervisor or Director of any reoccurring problems or issues immediately.
Run your ATB twice a month to check for problem visits.
Follow-up on visits that have no follow-up activity after the 28th date of the visit being billed.
Document your work in Notes B consistently and in detail for all accounts worked.
Letters requesting additional information from the patient or insured should be utilized only when you are unable to reach by phone or calls are unreturned. This is to ensure claims are billed and paid timely.
All refunds should be worked promptly, and the Refund worklist should be kept at 50k or less.
Assist with the Credit Balance report which prints weekly and is disbursed accordingly.
Manage and comply with all rules and regulations specific to the accounts you are assigned.
Attach all implant invoices and supportive documentation to the claim and submit promptly per contract with each payer.
Retain and maintain all third-party payer remittance and status reports that you are in receipt of.
Consistently identifies accurate FSC/Plan for visits, ensures patient’s account is billed accurately by consistently utilizing “AW” function, and strives to be proactive by educating departments as needed on accuracy of FSC/Plan assignment.
Always set an example of teamwork and a professional attitude.