PATIENT ACCOUNTS REP

UHS•Brentwood, TN

3d•Onsite

About The Position

This position is responsible for processing insurance claims for assigned facilities in a timely manner. This position ensures review and collecting of payments from insurance agencies and patients for the assigned facilities. This position requires collaboration between the insurance agencies, the facility, and the patient in resolving any problems that may occur during each Revenue Cycle. Success in this position is driven by strong communication skills, a proactive approach to resolving claim-related issues, and the ability to maintain a courteous and professional demeanor when interacting with patients, coworkers, and external agencies. The ideal candidate brings adaptability, attention to detail, and a collaborative mindset to ensure smooth and efficient operations throughout the Revenue Cycle.

Requirements

High School Graduate/GED Required
1-3 Years Related work experience required
Understanding of billing requirements for commercial payers and Medicaid.
Understanding of Explanation of Benefits – Remittance Advice
Understanding of both UB04 claim form, CMS 1500 claim form.
Knowledge of Microsoft, Excel, Word.
Knowledge of basic medical coding and third-party operating procedures and practices
Effectively interact with patients and co-workers in a professional, courteous manner

Nice To Haves

Vocational Technical School Graduate preferred
3-5 years preferred

Responsibilities

Processes the filing for all assigned claims. Ensures requirements are met and claims are followed-up on daily to eliminate denials and non-payment of claims.
Reviews and conducts research on insurance correspondence and makes necessary corrections to ensure appropriate claims payment.
Conducts research and follow-up on denials in a timely manner and proactively communicates any denial issues related to billing requirements. Completes re-bill request as necessary to facilitate timely and proper claims payment.
Contact and explain insurance benefits and collect payments to patients. Resolve any issues related to the patient accounts and negotiate any overdue balance to recover payments form patients. Assist patients with terms for payment plans when necessary.
Monitors contracts and single patient agreements to ensure appropriate reimbursement is received. Reviews each eligibility of benefits (EOB) for proper reimbursement and answer inquiries and correspondence from patients and insurance companies to facilitate payment.
Manages assigned projects related to obtaining appropriate and timely reimbursement of outstanding claims and performs various collection actions including contacting third party payers or patients by phone