Patient Accounts Rep 3 - Insurance Billing

The Doctors Clinic • Silverdale, WA

15h • $20 - $29

About The Position

Ensure a high level of customer service is maintained in the area of patient accounts including billing, collections and billing adjustments.

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 or other third parties.
• Ability to professionally represent the clinic’s interests and patient concerns with parties outside of the clinic setting.
• Ability to provide leadership to groups.
• Ability to multi-task efficiently and effectively.
• Must possess knowledge of coding and clinical operating policies and procedures.
• Must be able to prepare and examine documents for accuracy and completeness, correcting errors.
• Must be able to act calmly and effectively in a busy or stressful situation.
• Requires adherence to all policies and procedures, including standards for safety, attendance, punctuality and personal appearance.
• Must be able to establish and maintain effective working relationships with managers and peers.
• Hearing: Adequate to perform job duties in person and over the telephone.
• Speaking: Must be able to communicate clearly to patients and coworkers in person and over the telephone.
• Vision: Visual acuity adequate to perform job duties, including reading information from printed sources and computer screens.

Nice To Haves

• 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. Identify internal and external sources to answer complex questions and resolve detailed problems.
• 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. Use information gathered in the monitoring process to notify insurance company and manager of inconsistencies.
• Identify claims payment slowdown notifying manager. Assist in action to remedy.
• Maintain appropriate, levels of aging on assigned insurance types to insure no claims become untimely. When problems arise, immediately take corrective action as prescribed by supervisory personnel to remedy.
• Work closely with Patient Accounts Rep IV’s and/or Coding and Compliance Department to identify and correct causes for denied claims, payment delays and downcoding.
• Must have an understanding and/or basic knowledge of all the duties of the Patient Accounts I and II positions including the ability to perform the jobs if needed. May cross-train on the Patient Accounts III-Customer Service position.
• Prioritize work received and complete in a timely manner.
• Assist other office personnel in the performance of their duties as assigned and as workload permits.
• Maintain confidentiality of sensitive information.
• Work as a team member within the business office and all other departments in a collaborative, constructive manner.
• Document work processes as required.
• Perform other duties as assigned.

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
• Career Level: Mid Level
• Education Level: High school or GED