Senior Patient Account Representative - Pre-Visit Services/Authorizations

OU Health•Oklahoma City, OK

2d•Hybrid

About The Position

The Senior Patient Account Representative - Pre-Visit Services/Authorizations role serves as a crucial link between insurance companies and the services provided to patients at OU Health. This position is responsible for handling authorizations and referrals, ensuring seamless processing of patient accounts and receivables. The role involves various aspects of patient processing, including billing, charge entry, collections, registration, scheduling, follow-up, coding, payment posting, and credit balance resolution. The ideal candidate will possess strong experience in these areas and be adept at using medical billing systems.

Requirements

High School Diploma or GED.
3-5 years of experience in Medical Billing, Medical Collections, Medical Billing Systems (IDX or other billing system) required.
Attention to detail
Excellent verbal and written communication skills
Proficient with the use of Microsoft Office tools

Nice To Haves

Candidates must reside and work full-time in OK before their first day of employment.

Responsibilities

Patient scheduling
Patient registration
Review patient admitting records and extracts relevant information
Records patient identification and demographic information in the computerized billing system
Contacts agency representatives to verify type and extent of coverage.
Charge entry
Performs preliminary review of source documents to determine that sufficient data are present for processing
Using alphanumeric keyboard, transcribes and/or verifies data from source documents to the medium used for entering data into the computer
Batch charges
Generate cash totals
Enter charges
Balances batches by comparing batch proofs to source documents and hash totals
Billing
Works with all areas of the organization in getting any necessary or requested documentation for patients, insurance carriers or other areas.
May interact with hospital patient accounting or records personnel to obtain patient demographic or other billing information
Operates hospital information system terminal to obtain patient demographic information, patient insurance information and status of approvals or denials
Completes processing of all inpatient and outpatient documents received on a daily basis
Assists in resolving department problems with IDX billing
Maintains records of charges, payments, third party charges, etc.
Collection
Answers patient’s questions regarding statements, agency coverage, etc.
Handles correspondence regarding collection activity and records results
Identify patient accounts for collection action when accounts become delinquent or when unable to contact patient or responsible party
May receive patient payments and/or issue payment receipts
Coding
Record CPT codes on billing form
Record ICD-9 codes on billing form
Follow-up
Initiates contact with patients and/or third party carriers if there is a delay in responding to statements or claims
May process incoming and outgoing mail
May receive incoming telephone calls and resolve issues communicated
Records results of mail and telephone contacts on the computer billing system
Contacts insurance carriers regarding non-payment and/or improper payment of claims
Reviews denials
Interfaces with patients, physicians, and others regarding professional billing operations and funds
Payment posting
Post receipts to proper patient accounts
Post denials
Compare batch proofs and source documents for accuracy
Reporting
Assists in reviewing and balancing IDX transaction reports for administration
Reconciles daily IDX receivables reports
Prepares billing statements from statistical data
Credit balance resolution
Review daily billing and accounts receivable credit balance reports
Prepare daily refund check requests
Prepare other daily credit balances other than refunds
Post refund checks to patient accounts
Mail refund checks with supporting documentation
Performs other duties as assigned.