Patient Account Representative - Urology - Center City - Full-Time Days

Jefferson Health Plans • Philadelphia, PA

10d • Onsite

About The Position

This role is responsible for reviewing and maintaining patient billing accounts. The Patient Account Representative will handle tasks such as totaling, batching, and entering charges into the billing system, working with collection agencies, patients, and staff, and sending claims and bills to patients and insurance carriers. The position also involves ensuring appropriate coding, obtaining necessary data from physicians, reviewing explanations of benefits, and posting payments. Additionally, the representative will follow up on rejected or underpaid claims, stay current with insurer and regulatory changes, handle telephone billing inquiries, and assist physicians with billing-related questions. The role requires reviewing accounts receivables, establishing work priorities, ensuring quality and conformance to departmental policies, and assisting with staff training. Other duties include reviewing claim edit lists, ensuring documentation for paper claims, initiating paperwork for refunds, adjusting outstanding balances, and providing coverage for other billing personnel.

Requirements

• High School Diploma or GED equivalent required.
• Minimum of three years of billing experience in a multi-specialty group practice.
• Current knowledge of third-party rules and regulations.
• Must possess the ability to accurately analyze and identify errors.
• Demonstrated experience in area of physician coding, billing and registration.
• Attention to detail is essential.

Responsibilities

• Totaling, batching, and entering charges into the billing system for physician activity.
• Working closely with collection agencies, patients, practices, and staff regarding collection activities.
• Sending claims and physician bills to patients and various third-party insurance carriers.
• Ensuring all procedures and diagnosis coding is done appropriately.
• Ensuring all data regarding procedures performed is obtained from physicians.
• Reviewing explanation of benefits received to ensure proper payment from the insurance company.
• Posting patient and third-party payments to accounts in the IDX system.
• Interacting with co-workers, visitors, and other staff consistent with the core values of the University.
• Following up on rejected or underpaid claims.
• Remaining current and knowledgeable regarding all insurer and regulatory changes (includes Medicare, Medicaid, and all Managed Care Programs with whom department participates).
• Handling telephone billing inquiries from patients and insurance companies.
• Handling inquiries from Practice Physicians concerning billing inquiries, and working with physicians to ensure proper patient account write-off.
• Reviewing and maintaining all patient accounts with current insurance coverage.
• Periodically reviewing individual accounts receivables as directed by supervisor.
• Assisting in establishing work priorities, including projects and non-routine assignments.
• Reviewing work for quality and conformance to departmental policy.
• Assisting with training of assigned staff.
• Reviewing claim edit lists for missing or incorrect registration data, diagnostic or procedure codes. Referring edits to practices where appropriate for resolution.
• Ensuring that all necessary documentation is attached to paper claims, including operative notes, referrals, EOBs of benefits for secondary insurance and Act 44 (WC) and Act 6 (Auto) reports.
• Initiating paperwork for patient or third-party refunds.
• Adjusting outstanding balances for contractual adjustments and professional courtesy according to JUP policies and procedures.
• Handling billing inquiries from patients and third-party payors where appropriate.
• Providing coverage and support to other billing personnel in the JUP Business Services Office as required.
• Performing other duties or special projects as assigned.

Benefits

• Medical (including prescription) insurance
• Supplemental insurance
• Dental insurance
• Vision insurance
• Life and AD&D insurance
• Short- and long-term disability
• Flexible spending accounts
• Retirement plans
• Tuition assistance
• Voluntary benefits (group rates on insurance and discounts)
• Tuition discounts at Thomas Jefferson University (after one year of full-time service or two years of part-time service)

What This Job Offers

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