Patient Representative Biller

Sullivan County Community Hospital•Sullivan, IN

About The Position

QUALIFICATIONS Education High school graduate or equivalent Experience/Skills Athena experience preferred Possesses knowledge of business office operations Understands third party billing requirements Understands Medicare/Medicaid inpatient and outpatient billing Strives for customer satisfaction when responding to all patient/customer inquires (internal customers) Experience using office equipment Adapts professionally to changes in procedures and/or workload Possesses excellent written and oral communication skills Works independently with little supervision Maintains concentration Remains committed to a “cross training” philosophy for all assigned tasks Working Conditions Works in a well-ventilated, well-lit general office environment Works well under pressure with attention to time constraints ROUTINE RESPONSIBILITIES Behavioral Expectations Consistently complies with established Behavioral Expectations Essential Duties Reviews, identifies, and corrects claims issues identified in inhouse hold and the claim scrubbing holds Sends clean, timely claims out on first billing Works reconciliation desktops to ensure upfront rejection of claims are processed and resubmitted to correct payer Reviews assigned outstanding accounts receivable by using ATB, queues, and payment reports Submits timely and accurate adjustments documenting activity in account Understands and manages denials, submitting timely disputes and appeals Follows up with insurance companies to ensure claims are processed and paid correctly according to contract Understands payor contracts and billing guidelines. revenue codes, cpt codes, modifiers, and payor-specific guidelines Investigates and reports claims denial trends with payer documentation for departments to review and establish action plan Provides back-up phone support to billing lines daily

Requirements

High school graduate or equivalent
Possesses knowledge of business office operations
Understands third party billing requirements
Understands Medicare/Medicaid inpatient and outpatient billing
Strives for customer satisfaction when responding to all patient/customer inquires (internal customers)
Experience using office equipment
Adapts professionally to changes in procedures and/or workload
Possesses excellent written and oral communication skills
Works independently with little supervision
Maintains concentration
Remains committed to a “cross training” philosophy for all assigned tasks
Works well under pressure with attention to time constraints

Nice To Haves

Athena experience preferred

Responsibilities

Reviews, identifies, and corrects claims issues identified in inhouse hold and the claim scrubbing holds
Sends clean, timely claims out on first billing
Works reconciliation desktops to ensure upfront rejection of claims are processed and resubmitted to correct payer
Reviews assigned outstanding accounts receivable by using ATB, queues, and payment reports
Submits timely and accurate adjustments documenting activity in account
Understands and manages denials, submitting timely disputes and appeals
Follows up with insurance companies to ensure claims are processed and paid correctly according to contract
Understands payor contracts and billing guidelines. revenue codes, cpt codes, modifiers, and payor-specific guidelines
Investigates and reports claims denial trends with payer documentation for departments to review and establish action plan
Provides back-up phone support to billing lines daily