Patient Coverage Representative
About The Position
The Patient Coverage Representative role is within the Enterprise Revenue Cycle - Revenue Cycle Support: Southeast department and is a full-time position eligible for benefits. The position operates remotely with standard business hours of 8 am to 5 pm. The primary function is to handle patient phone coverage, update information in the Electronic Health Record (EHR), initiate claims, and ensure accurate primary and secondary payor information. This involves reviewing eligibility transactions, managing Customer Relationship Management (CRM) requests, following up on insurance changes via the EHR Patient Portal, updating guarantor accounts, and correcting data discrepancies in hospital account records (HARs) and visits. The role also involves working EHR workqueues related to patient demographics, guarantors, and coverage information.
Requirements
- Typically requires 2 years of experience in health care, with focus on registration, insurance, and billing.
- Knowledge and understanding of Revenue Cycle-specific insurance and billing procedures preferred.
- Previous data entry experience and demonstrated proficiency with emphasis on speed with accuracy.
- Good organizational ability as well as solid written and verbal communication skills.
- A basic understanding of EHRs, with the ability to gain deeper knowledge.
- Knowledge of Medicare, Medicaid and third-party payors.
- Knowledge of medical terminology.
Responsibilities
- Receives incoming calls from patients and business office team members to perform coverage updates.
- Updates information in the Electronic Health Record(s) (EHR) to ensure coverage is verified and accurate.
- Ensures appropriate steps are taken to initiate claims on affected transactions.
- Performs updates based on Visit Filing Order changes daily, ensuring claims are sent to the correct primary and/or secondary payor.
- Reviews electronic eligibility transactions returned for patients with upcoming services, as well as for services that have already been billed to the patient, performing the necessary updates to coverage as needed to ensure accuracy of coverage information.
- Sends and receives Customer Relationship Management requests (CRM) to communicate with other team members in the business office regarding patient-initiated insurance concerns.
- Follows up on patient-initiated insurance changes through the EHR Patient Portal and makes updates as necessary.
- Performs guarantor account updates based on patient-initiated requests, ensuring the appropriate guarantor type is being used based on billing requirements.
- Updates hospital account records (HARs) and visits to ensure Smart Chart identified data discrepancies are corrected.
- Works other EHR workqueues related to patient demographic, guarantor, and coverage information as needed.
Benefits
- Comprehensive suite of Total Rewards
- Benefits and well-being programs
- Competitive compensation
- Generous retirement offerings
- Programs that invest in your career development
- 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
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
