PATIENT ACCOUNT REPRESENTATIVE - The Staff Pad : Job Details

PATIENT ACCOUNT REPRESENTATIVE

The Staff Pad

Job Location : Helena,MT, USA

Posted on : 2024-10-30T08:07:35Z

Job Description :

Summary:

The Staff Pad is honored to partner with a non-profit healthcare system in Helena, Montana with superior care and a hometown commitment to be the gold standard for health care in Montana. We are in search of a Patient Account Representative to join their team.

Responsibilities

  • Performs pre-billing and billing functions to insure successful outcome of claim submission and payment.
  • Follows all billing and regulatory guidelines, per insurance carrier, to insure facility compliance.
  • Collaborates with all Team Members within SPH to insure an accurate and timely billing.
  • Collect outstanding insurance company balances as quickly as possible by applying collection best practices as defined by Leadership
  • Utilize various A/R reports to target aged balances for collection to meet and maintain performance goals.
  • Evaluate partial payments to determine if further reimbursement is valid
  • Compose technical denial arguments for reconsideration, including both written and telephonically
  • Overcome objections that prevent payment of the claim and gain commitment for payment through concise and effective appeal argument
  • Escalate exhausted appeal efforts to Leadership
  • Submits retro authorization to insurance within insurance carrier guidelines
  • Researches and takes necessary action to follow up on unpaid claims using ATB's and/or assigned work lists
  • Works pending claims in the CMS Direct Data Entry software (DDE) and SPH claims Clearinghouse
  • Analyses insurance payments received to verify account was paid per contract, if not, contacts insurance to reprocess
  • Use effective documentation standards that support a strong historical record of actions taken on the account
  • Reviews and follows through on credit balances through take back initiation, refund initiation, and/or payment re-application.
  • Reports Medicare credits quarterly to Medicare on appropriate form and supplies all supporting documentation
  • Logs and adjusts all appropriate Medicare bad debt cancels so they can be reported on year-end financial reports.
  • Works patient and insurance correspondence timely. Respond and document in account and scan documents into patient account for future reference.
  • Response to all queries timely to insure Gold Standard Customer Service
  • Role requires adherence to quality assurance guidelines as well as established productivity standards to support the work unit's performance expectations
  • Qualifications

    KNOWLEDGE/EXPERIENCE:

    • Previous work experience in insurance billing regulations and understanding insurance contracts preferred but not mandatory
    • Knowledge of state and federal regulations as they relate to the billing process preferred but not mandatory
    • Proficient keyboard/ 10 key skills and working knowledge of computers required.
    • Good verbal and written communication skills.
    • Strong data entry, ten key skills and working knowledge of computer required.
    • Exceptional customer service and interpersonal communication skills.
    • Proficient in examining documents for accuracy and completeness.
    • Ability to multitask and manage time effectively.
    • Ability to grasp, retain, and apply new regulations
    • Mathematical, organization skill and business correspondence skills.
    • Basic knowledge in downloading/creating spreadsheets in Microsoft Excel

    EDUCATION: High School diploma or GED required. Completes Patient Financial Services I training within first 5 month

    PandoLogic. Keywords: Medical Records Analyst, Location: Helena, MT - 59604 , PL: 594915805
    Apply Now!

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