Patient Representative Biller
Sullivan County Community Hospital•Sullivan, IN
•Onsite
About The Position
This role involves reviewing, identifying, and correcting claims issues, ensuring timely and accurate claim submissions, and managing outstanding accounts receivable. The Patient Representative Biller will also be responsible for understanding and managing denials, following up with insurance companies, and investigating denial trends. Additionally, this position provides back-up phone support to billing lines.
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
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
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
