Patient Accounts Representative II

Duties:

Job Summary:
-This position will be responsible for researching and appealing outstanding medical claims.
-Monitoring assigned outstanding patient account claims and proactively identifies, researches and proposes solutions to trends.
-Responsible for identifying and following up on patient accounts in an appropriate manner to achieve maximum reimbursement and reducing Accounts Receivable in a timely manner.
-Research and follow up on outstanding claims.
-Document and appropriately file in the computer system all correspondence and action taken on an account.
-Follow up in accordance to procedures and policies with an overall goal of account resolution.
-Coordinate the correction of cash posting errors to patient accounts.
-Monitors assigned outstanding claims and proactively identifies, researches and proposes solutions to trends.
-Provides feedback to management regarding problem payers and specific reimbursement problems.
-Ensures proactive cash flow by maximizing reimbursement and reducing accounts receivable.
-Review the appeals process and complete adjustments within dollar amount thresholds.
-May be assigned to work with patient accounts associated to one or more specialized areas or insurance payers.
-This is including but not limited to, acute, ambulatory, medical specialty, provider based, commercial, government, or other third-party payers.
-Keep current in payer and contract terms, updates, billing policies, and navigation of respective payer websites.
-Interprets payer contract summaries with advanced understanding to evaluate under and over payments.
-Responsible for meeting productivity and quality goals.
-Serve as a subject matter expert, resource and mentor to others within the department.
-May train new associates and provide feedback on work performance. null

Skills:

Required Skills & Experience:
-Experience more than 1 year and less than 3 years.
-Must have minimum of 1 years experience in medical billing/patient accounts.
-General computer skills.
-Typing, 10-key.
-Advanced proficiency level with MS Office products including Word and Excel.
-Advanced level knowledge of medical billing, insurance, and compliance regulations and coding.
-Medical terminology.
-Advanced knowledge of Epic.

Preferred Skills & Experience:
-Experience more than 3 years and less than 5 years.
-Hospital/Physician billing or claims follow up experience. null