Pt Rec Rep- Medicare/Medicaid

Stamford Health•Stamford, CT

102d

About The Position

Ensure prompt, accurate, and compliant billing and payments for all Medicaid and Medicare patient claims. 2. Resolve failed billing edits, under/over or denied payments by Medicare and Medicaid. Monitor the resolution and involve ancillary departments as needed using the tasking function when applicable. 3. Keep current with the changes to the Medicare and Medicaid regulations and billing protocols. Have a clear understanding of how these changes will impact the Hospital's departments. 4. Accurate billing and follow-up of patient accounts according to established departmental guidelines based upon regulation requirements. 5. Monitors and reconciles daily reports as well as assigned worklist for appropriate account resolution inclusive to credit, debit and adjustments. 6. Documentation of all action taken on an account. 7. Completes all projects as assigned. 8. Maintains department standards of productivity. 9. Performs other related duties as assigned or requested to maintain a high level of service. 10. Demonstrates professional work behavior by following Service Standards and Success factors. 11. Complies with departmental organizational policies and procedures and adheres to external agency requirements. 12. Providing timely and accurate information regarding patient data/status to other health system departments, physicians, physician office staffs, and other publics while ensuring patient confidentiality is not breached.

Requirements

Two years college, and/or three years prior equivalent experience in a hospital setting with experience in medicare, medicaid or commercial billing and follow up.
Computer literacy in PC environment is required with strong organizational, analytical, interpersonal and communication skills.

Nice To Haves

Meditech experience a plus.

Responsibilities

Ensure prompt, accurate, and compliant billing and payments for all Medicaid and Medicare patient claims.
Resolve failed billing edits, under/over or denied payments by Medicare and Medicaid.
Monitor the resolution and involve ancillary departments as needed using the tasking function when applicable.
Keep current with the changes to the Medicare and Medicaid regulations and billing protocols.
Have a clear understanding of how these changes will impact the Hospital's departments.
Accurate billing and follow-up of patient accounts according to established departmental guidelines based upon regulation requirements.
Monitors and reconciles daily reports as well as assigned worklist for appropriate account resolution inclusive to credit, debit and adjustments.
Documentation of all action taken on an account.
Completes all projects as assigned.
Maintains department standards of productivity.
Performs other related duties as assigned or requested to maintain a high level of service.
Demonstrates professional work behavior by following Service Standards and Success factors.
Complies with departmental organizational policies and procedures and adheres to external agency requirements.
Providing timely and accurate information regarding patient data/status to other health system departments, physicians, physician office staffs, and other publics while ensuring patient confidentiality is not breached.