Billing FollowUp PT Acct

Chesapeake Regional Healthcare•Chesapeake, VA

12d

About The Position

The Patient Accounts Representative –Hospital Billing and Follow-up ensures the submission of timely and clean Inpatient/Outpatient claims to the various government/non-government payers and takes the appropriate action to resolve claim issues in order to accelerate cash collections. Essential Duties and Responsibilities These duties and responsibilities described below represent the general tasks performed on a daily basis; other tasks may be assigned.

Requirements

Minimum Required Education: High school diploma or equivalent
Experience: 3+ years as a Hospital Biller or Follow-up representative preferred
This position is responsible for revenue cycle operations specifically for Home Health and Hospice services.
Candidates must have prior experience in Home Health/Hospice billing, collections, and payer relations

Nice To Haves

Preferred Education: College courses or associate’s degree

Responsibilities

Submit Inpatient/Outpatient electronic and paper claims (UB-04 and 1500) to the appropriate government and non-government payers.
Understand how to resolve Billing errors and/or warnings that are identified in the Patient Accounting and Billing System.
Keep abreast of payer-specific and government requirements and regulations.
Ensures claim information is complete and accurate in order to accelerate cash collections.
Analyze information contained within the Patient Accounting and Billing system to make decisions on how to proceed with the billing of an account.
Processes rejections by correcting any billing error and resubmitting claims to government and non-government payers.
Place unbillable claims on hold and properly communicate to various Hospital departments the information needed to accurately bill.
Process late charge claims in the event that charges are not entered in a timely fashion by Hospital Departments.
Submit corrected claims in the event that the original claim information has changed for various reasons.
Perform the billing of complex scenarios such as interim, self-audit, combined, and split billing etc.
Limit the number of unreleased claims by reviewing all imported claims and either billing or holding the claim for further review.
Meet Billing productivity and quality requirements as developed by Leadership. Measured on high production levels, quality of work output, in compliance with established CRH’s policy and standards.
Record or generate revenue by gathering and processing information that impacts the patient revenue process.
Review patient financial records and/or claims prior to submission to ensure payer-specific requirements are met.
Keep abreast of payer-specific and government requirements and regulations
Follow up on unprocessed or unpaid claims until a claims resolution is achieved
Generates letters to insurance or patients as needed in order to resolve unpaid claim issues.
Works on and maintains spreadsheets by sorting/adding pertinent data
Analyze information contained within the billing systems to make decisions on how to proceed with the account.
Work independently and has the ability to make decisions relative to individual work activities
Identify comments in the billing systems by using initials and using approved abbreviations for universal understanding
Keep documentation clear, concise, and to the point, while including enough information for a clear understanding of the work performed and actions needed
Create appropriate documentation, correspondence, emails, etc. and ensure that they are scanned to the proper account for accurate documentation
Read, understand, and explain benefits from all payers to coworkers, physicians, and patients
Make phone calls, use the internet, and send mail to payers for follow-up on unprocessed claims, incorrectly processed claims, or claims in question
Develop relationships with customers/patients/co-workers in order to gather and process information or resolve issues in order to receive accurate reimbursement and optimize internal and external customer satisfaction
Post accurate adjustments as appropriate per billing policies and procedures, payer explanation of benefits, and the management directive
Maintain work procedures pertinent to the job assignment
Accountable for individual work activities
Resolve questions that arise regarding correct charging and/or other concerns regarding services provided
Complete cross-training, as deemed necessary by management, to ensure efficient department operations
Report potential or identified problems with systems, payers, and processes to the manager in a timely manner.
Complete special project assignments in a timely fashion
Follows HIPAA guidelines in order to maintain strict confidentiality of all patient financial and hospital information at all times.
Perform other duties as assigned