Patient Accounts Representative (Government Team)

About the position

Perform third party billing functions within established third party regulations and requirements. Responsible for all aspects of hospital/professional claim review and resolution.

Responsibilities

• Work assigned work queues daily/weekly to resolve claim denials in Cerner to ensure correct reimbursement and to avoid timely filing issues.
• Demonstrates computer literacy appropriately within the Cerner and SSI systems and Third Party Web Sites.
• Examine incoming correspondence and review rejections to determine if further follow up is necessary.
• Processes third party refunds. Research and resolve misapplied monies that have been posted to accounts incorrectly.
• Ability to resolve problems with limited supervision. Focuses on quality improvements while problem solving.
• Monitor follow up reports. Identify repeat claim errors by payer. Take appropriate action on delinquent accounts.
• Reports ongoing billing problems to the Patient Accounts Supervisor so a solution may be found and implemented to avoid further problems.
• Under the direct supervision of the Patient Accounts Supervisor and within established Hospital and departmental policies and procedures performs billing functions in order to bring accounts to resolution within a reasonable time frame.
• Use all resources, including guidebooks, payer websites, etc., to resolve any claim issues before reaching out to management.

Requirements

• High School Diploma or equivalent
• Minimum of 2 years of third party hospital/physician billing experience
• Excellent communication skills
• Attain and maintain knowledge of billing/accounts receivable data processing procedures and systems for the purpose of performing daily routine data entry that is required for the billing process.

Nice-to-haves

• Ability to multi-task
• Work well in a team environment
• Medicare billing experience is preferred.