Patient Financial Rep I

Great Plains Health•North Platte, NE

1d•Onsite

About The Position

The Patient Representative is responsible for timely monitoring of patient accounts from billing through final resolution. This includes follow-up with insurance companies, assisting patients with financial and billing questions, making payment arrangements, and performing collection activities when necessary. The role is part of the dynamic team at Great Plains Health, an independent hospital that fosters a culture of authenticity, integrity, and collaboration. The organization is committed to listening to both patients and team members, striving for excellence, innovation, and world-class quality in patient care, and supporting professional growth.

Requirements

High school diploma or equivalent required.

Responsibilities

Work the system created work list to follow up on accounts the same day they appear on the work list.
Answer incoming calls from insurance companies and patients, assisting them with any issues with resolution within 2 working days.
Combine multiple patient accounts to one guarantor if requested by the guarantor and set up payment plans on patient balances.
Ensure that follow-up and resolutions occur on patient account balances and provide customer service for patients.
Follow-up on denied or partially paid claims.
Resolve contractual differences with insurance companies for contracted plans.
Communicates effectively to payers to ensure accurate and timely electronically filed claims as per department guidelines.
Resolves patient complaints and requests regarding insurance billing and initiates accurate account adjustment.
Follows all billing problems to conclusion.
Manages department multi-line phone.
Transfers calls as appropriate.
Answers patient questions within prescribed guidelines.
Review patient demographics and make changes as appropriate.
Enter demographics as needed.
Update patient insurance information to guarantee correct insurance billing.
Ability to understand the components of remittance advices from various payers.
A thorough understanding of the specific payment business rules for each type of insurance – Medicare, Medicaid, Workers Compensations, Commercial insurance, etc.
Submits all paper claims and supporting documentation as required by payers.
Generate HCFA 1500 if needed.
Print all paper claims and appropriate documentation to be sent to both primary and secondary insurance companies.
Enter notes on the account, appropriately and timely, which would include claims information, issues, and general correspondence allowing anyone to understand the activity on the account.
Take action on any correspondence within 2 days of receiving the correspondence and noting the action taken.
Ability to manage account work-lists and daily mail within the prescribed time lines established for the department.
Ability to document in the Practice Management System, in a clear and concise manner, the details of all interactions relative to a patient' account.
Additional duties as assigned.