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

Thomas Jefferson University • Philadelphia, PA

8d • Onsite

About The Position

This position is responsible for reviewing and maintaining patient billing accounts. The role involves totaling, batching, and entering charges into the billing system, working with collection agencies, patients, and staff regarding collection activities, and sending claims and physician bills to patients and third-party insurance carriers. The representative will ensure appropriate coding, obtain necessary data from physicians, and review explanations of benefits to ensure proper payment. Posting patient and third-party payments, handling telephone inquiries, and assisting physicians with billing inquiries are also key responsibilities. The role requires following up on rejected or underpaid claims, staying current with insurer and regulatory changes, and reviewing individual accounts receivables as directed by a supervisor. Additionally, the position involves assisting in establishing work priorities, reviewing work for quality, assisting with training, and ensuring necessary documentation is attached to paper claims. Initiating paperwork for refunds and adjusting outstanding balances according to policies are also part of the duties. The role may also involve providing coverage and support to other billing personnel and undertaking other assigned duties or special projects.

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

• Responsible for totaling, batching and entering into billing system charges for physician activity.
• Works closely with collection agencies as well as with patients, the practices and all staff regarding collection activities.
• Sends claims and physician bills to patients and various third-party insurance carriers.
• Ensures all procedures and diagnosis coding is done appropriately.
• Ensures all data regarding procedures performed is obtained from physicians.
• Reviews explanation of benefits received to ensure proper payment from the insurance company.
• Posts patient and third party payments to accounts in the IDX system.
• Interacts with co-workers, visitors, and other staff consistent with the core values of the University.
• Follows-up rejected or underpaid claims.
• Remains current and knowledgeable regarding all insurer and regulatory changes (includes Medicare, Medicaid, and all Managed Care Programs with whom department participates).
• Handles telephone billing inquiries from patient and insurance companies.
• Handles inquiries from Practice Physicians concerning billing inquiries, work with physicians to insure proper patient account write-off.
• Reviews and maintains all patient accounts with current insurance coverage.
• Periodically reviews individual accounts receivables as directed by supervisor.
• Assists in establishing work priorities, including projects and non-routine assignments.
• Reviews work for quality and conformance to departmental policy.
• Assists with training of assigned staff.
• Reviews claim edit lists for missing or incorrect registration data, diagnostic or procedure codes.
• Refers edits to practices where appropriate for resolution.
• Ensures 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.
• Initiates paperwork for patient or third party refunds.
• Adjusts outstanding balances for contractual adjustments and professional courtesy according to JUP policies and procedures.
• Handles billing inquiries from patients and third party payors where appropriate.
• Provides coverage and support to other billing personnel in the JUP Business Services Office as required.
• Other duties or special projects as assigned.

Benefits

• medical (including prescription)
• supplemental insurance
• dental
• vision
• life and AD&D insurance
• short- and long-term disability
• flexible spending accounts
• retirement plans
• tuition assistance
• voluntary benefits
• 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