Patient Services Representative

Lifepoint Health • Ottumwa, IA

19d

About The Position

Ottumwa Regional Physicians Admin, part of Lifepoint Health, is seeking a Patient Services Representative to complete insurance claims for patient services and follow up to ensure prompt and accurate payment. The role works Medicare rejections received from IVANS daily and rekeys them through the DDE system, maintains knowledge of CMS billing rules and regulations, handles complex billing issues, manages Medicare bad debt and Patient Financial Services denial logs, and submits primary Medicare first-level appeals after approval from PFSD. This position is PRN and scheduled as needed.

Requirements

• Minimum of 4 years of insurance billing and follow-up experience.
• High school diploma required.

Nice To Haves

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

Responsibilities

• Ensure collection of funds for hospital billable services so goals for bad debts, accounts receivable days, and cash collections are met.
• 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 maximize cash flow.
• Investigate and seek explanations for denials and rejections.
• Adhere to standards established by the Health Insurance Portability and Accountability Act (HIPAA) of 1996.
• Work Medicare rejections from IVANS daily and rekey them through the DDE system.
• Maintain knowledge of CMS billing rules and regulations.
• Handle complex billing issues.
• Manage the Medicare Bad Debt Log for monthly submission, including reviewing Medicaid remittances daily for Medicare qualifying accounts and logging agency returns for accounts over 120 days that PFSD provides for review.
• Manage the Patient Financial Services Denial Log.
• Submit primary Medicare first-level appeals after approval from PFSD.

Benefits

• Health insurance, 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