Patient Accounts Rep 3

The Doctors Clinic • Silverdale, WA

87d • $20 - $29

About The Position

The Patient Accounts Representative III - Insurance Billing is responsible for ensuring a high level of customer service in the area of patient accounts, including billing, collections, and billing adjustments. The role involves ensuring that billing occurs in accordance with clinic procedures and standards, identifying and correcting missing data elements prior to claims submission, and maintaining a working knowledge of health plans. The representative will follow up with insurance companies to ensure claims are paid, monitor reimbursements for accuracy, file appeals on denied claims, and investigate billing problems. The position requires collaboration with other departments and maintaining confidentiality of sensitive information.

Requirements

• High school diploma or equivalent.
• Minimum 3 years experience in customer service.
• Minimum 2 years experience in medical billing practices.
• Ability to communicate in the English language in person, by phone and in writing in a clear, concise and professional manner.
• Ability to resolve problems with minimal assistance.
• Ability to utilize sound judgment in making and implementing corrective action.
• Medical terminology required.
• Basic computer and keyboarding skills.
• Strong organizational and interpersonal skills.
• Experience with conflict management.
• Excellent verbal communication skills.
• Ability to independently write correspondence appropriate for mailing to patients and insurance companies.
• Ability to professionally represent the clinic's interests and patient concerns.
• Ability to provide leadership to groups.

Nice To Haves

• Certification/Licensure: CPC preferred.

Responsibilities

• Ensure that billing is occurring in accordance with all applicable clinic procedures and standards.
• Identify and correct missing data elements prior to claims submission.
• Audit claims prior to submission on electronic system.
• Maintain working knowledge of the health plans with which the clinic contracts.
• Follow up with insurance companies ensuring that claims are paid.
• Monitor reimbursements received for accuracy of contracted payment rates and regulations.
• File appeals on denied claims, insufficient payments and/or overstated disallowed amounts in a timely manner.
• Re-file claims with additional supporting documentation to obtain higher reimbursement as necessary.
• Respond to carrier inquiries for additional information including contacting practices to obtain additional documentation to support resubmission of claims.
• Review audit reports to ensure that payments are posted accurately.
• Investigate billing problems and formulate solutions for review and implementation.
• Initiate refund requests for incorrect insurance payments.
• Monitor payer reimbursement turnaround time of 30 - 45 days.
• Identify claims payment slowdown notifying manager.
• Maintain appropriate levels of aging on assigned insurance types to ensure no claims become untimely.
• Work closely with Patient Accounts Rep IVs and/or Coding and Compliance Department to identify and correct causes for denied claims, payment delays and downcoding.
• Understand and/or have basic knowledge of all the duties of the Patient Accounts I and II positions.

Benefits

• Medical/Dental/Vision Insurance
• Health Savings Account (HSA), or Health Reimbursement Arrangement (HRA)
• Paid Holidays
• Paid Time Off (PTO)
• Long Term Illness (LTI) Leave
• 401(k) Retirement Plan and Profit Sharing
• Group Life, Accidental Death & Dismemberment (AD&D), Long-Term Disability (LTD) Insurance

What This Job Offers

• Job Type: Full-time
• Industry: Ambulatory Health Care Services
• Education Level: High school or GED