Patient Services Representative

Lifepoint Health • Ottumwa, IA

13d

About The Position

The Patient Services Representative completes insurance claims for patient services and follows up to ensure prompt and accurate payment. The role includes working Medicare rejections from IVANS daily and rekeying them through the DDE system, maintaining knowledge of CMS billing rules and regulations, handling complex billing issues, managing Medicare bad debt and Patient Financial Services denial logs, and submitting primary Medicare first-level appeals after approval from PFSD.

The representative supports collection goals for hospital billable services, cash management, accurate claims processing, account follow-up, and communication with patients and third-party payers. This is a PRN, as-needed position with Ottumwa Regional Physicians Admin, part of Lifepoint Health.

Requirements

• High school diploma required.
• At least 4 years of insurance billing or follow-up experience required.

Nice To Haves

• Associate’s degree or higher preferred.
• Coding experience preferred.

Responsibilities

• Complete insurance claims for patient services and follow up to ensure prompt and accurate payment.
• Ensure collection of funds for hospital billable services to meet goals for bad debts, accounts receivable days, and cash collections.
• Support the Director of Patient Accounting in maximizing income through cash management.
• Maintain accuracy in paper and electronic claims processing.
• Follow up on accounts to ensure claims are paid promptly and correctly.
• Explain hospital charges, insurance payments, and insurance coverage to patients who inquire.
• Develop relationships with third-party payers and vendors to help maximize cash flow.
• Inquire about and seek explanations for denials and rejections.
• Adhere to HIPAA standards.
• Work Medicare rejections from IVANS daily and rekey them through the DDE system.
• Handle complex billing issues and maintain knowledge of CMS billing rules and regulations.
• Manage the Medicare Bad Debt Log for monthly submission, including reviewing Medicaid remits daily for Medicare-qualifying accounts and reviewing agency returns provided by PFSD for accounts over 120 days.
• Manage the Patient Financial Services Denial Log.
• Submit primary Medicare first-level appeals after approval from PFSD.

Benefits

• Health benefits, including medical, dental, and vision, for full-time employees.
• 401(k) benefits for full-time employees.
• Competitive paid time off.
• Employee Assistance Program offering mental, physical, and financial wellness assistance.
• Tuition reimbursement or assistance for qualified applicants.

What This Job Offers

• Education Level: High school or GED