Patient Accounts Rep Ld
About The Position
This position is responsible for daily claims submissions to the appropriate payer source. The role involves communicating with internal and external parties to resolve charging issues affecting claims and reporting trends to other departments that may improve the claims submission process. The Patient Accounts Rep Ld may also be responsible for the collection of an assigned section of insurance receivables, following all established procedures and guidelines. This includes reviewing assigned accounts and taking appropriate action for internal or external problems that may cause a delay in reimbursement, and responding to telephone or written correspondence regarding insurance claims. The role also involves applying contractual allowances where necessary, assisting the team with complex issues, providing training, and offering ongoing feedback on performance. Additionally, the position monitors and audits productivity and quality, analyzes daily statistics for trends, and reports these to management. The Patient Accounts Rep Ld attends required meetings, participates in outside seminars, and may serve as a "train the trainer." This role stays informed about insurance payor updates/changes and assists management with recommendations for implementation. It prioritizes rejections to avoid timely filing insurance appeal limitations, which may include denials. The Patient Accounts Rep Ld is accountable for assessing and resolving advanced projects as assigned, and researching/distributing new upgrades or information from Insurance Payers regarding contracts, guidelines, reimbursement rules and regulations, and computer systems.
Requirements
- High School Diploma or General Education Degree (GED)
- Typically requires 5 years of related experience in medical/billing reimbursement environment, or equivalent combination of education and experience.
- Proficient in all follow up rep functions.
- Demonstrated ability to work and solve billing / follow up issues in a healthcare environment.
- Broad and comprehensive knowledge and understanding of department-specific procedures.
- Strong analytic, organization, communication (written and verbal), and interpersonal skills.
- Ability to successfully lead, coach, and train a team, and problem solve complex accounts.
- Knowledge of medical terminology, coding terminology (CPT,ICD- 10,HCPC), and insurance/reimbursement practice.
- Able to use Zoom, Microsoft office, or other communication software for meetings.
Responsibilities
- Responsible for daily claims submissions to the appropriate payer source.
- Communicates with internal and external parties to resolve charging issues affecting the claims.
- Reports trends with other departments that may improve the claims submission process.
- May be responsible for collection of an assigned section of the insurance receivables, following all procedures and guidelines established.
- Reviews assigned accounts and takes appropriate course of action: internal or external problems that may cause a delay in reimbursement.
- Responds to telephone or written correspondence from internal and external parties regarding insurance claims.
- Applies contractual allowances where necessary.
- Assists team with more complex issues to resolve problems, provides necessary training, and provides ongoing feedback on performance.
- Monitors and audits productivity, quality and analyzes daily statistics looking for any trends which are reported to management.
- May provide feedback to Billing Rep I and II.
- Attends and participates in meetings as required, attend outside seminars and be used as “train the trainer”.
- Share training knowledge with others as appropriate.
- Keeps abreast with insurance payor updates/changes and assists management with recommendations for implementation.
- Prioritize rejections to avoid timely filing insurance appeal limitations, may include denials.
- Accountable to assess and resolve advanced projects as assigned.
- Research/Distribute new upgrades/information from the Insurance Payers re: Contracts, guidelines, reimbursement rules and regulations and for computer systems.
Benefits
- Comprehensive suite of Total Rewards: benefits and well-being programs
- Competitive compensation
- Generous retirement offerings
- Programs that invest in your career development
- Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training
- Premium pay such as shift, on call, and more based on a teammate's job
- Incentive pay for select positions
- Opportunity for annual increases based on performance
- Paid Time Off programs
- Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
- Flexible Spending Accounts for eligible health care and dependent care expenses
- Family benefits such as adoption assistance and paid parental leave
- Defined contribution retirement plans with employer match and other financial wellness programs
- Educational Assistance Program
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
