Patient Accounting Representative F/T

Description

• Under the guidance of the Revenue Cycle Director, the Government and Commercial Billing Managers are tasked with billing various account types, encompassing HMOs, PPOs, Worker’s’ Compensation, Government Payers and Self-pay accounts.
• Ensure all necessary documentation is present for billing patient accounts.
• Coordinates with various insurance carriers to meet standard requirements, ensuring appropriate payment of claims and adherence to guidelines before billing.
• Processes claims using the designated electronic billing system corresponding to the insurance plan, with any remaining claims billed in hardcopy to the relevant insurance carrier.
• Collaborates with relevant personnel and hospital departments to ensure accurate diagnosis and procedure coding on claims.
• Reviews past due accounts and associated documents to identify and access delinquency issues.
• Conducts reviews of claims denials, identifies root causes, and takes necessary actions, including follow-ups and appeals in a timely manner.

• Investigates reasons for claim denials to uncover any unique circumstances contributing to payment delays and communicates with relevant parties for follow-up, potentially seeking assistance from Payer Contracting, Case Management, and Health Information Management (HIM)/Coding departments.
• Executes a comprehensive array of tasks, potentially rotating assignments or specializing in a particular area as needed.
• Demonstrates proficiency in all computer systems essential for completing job responsibilities and comprehends the integration of information across all financial systems.

• Responsible for daily claims processing and billing
• Completes assigned work queues and handles daily incoming correspondence.
• Participates in mandatory annual events and education sessions.

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