Patient Account Representative - Medicare Experience Required

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Med-Metrix

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Revenue Cycle Management • Business Intelligence • Revenue Recovery • Managed Care Improvement • Physician Advisor Services

1001 - 5000 employees

⚕️ Healthcare Insurance

💸 Finance

☁️ SaaS

💰 Private Equity Round on 2021-09

Description

• The Patient Account Representative is responsible for collections, account follow up, billing allowance posting for the accounts assigned to them. • Follow-up with payers to ensure timely resolution of all outstanding claims, via phone, emails, fax or websites • Review and updates all patient and financial information accurately as given. • Verify that information is accurate as to individual or insurance company responsible for payment of bill. • Monitor all billings for accuracy, updating any that contain known errors. • Monitor Medicaid/healthy options coupons to assure services are billed within expected timeframes • Bill all hospital services to primary insurer or patient correctly and within expected timeframe • Follow up with insurance companies on all assigned accounts within expected timeframe • Explain hospital regulations with regard to methods for payment of accounts and maintains complete working knowledge of insurance regulations and hospital insurance contracts • Identify and report underpayments and denial trends • Analyze, identify and resolve issues causing payer payment delays; Initiate appeals when necessary • Manipulate excel spreadsheets and communicate results • Meet and maintain daily productivity and quality standards established in departmental policies • Act professionally, cooperatively and courteously with patients, insurance payors, co-workers, management and clients • Perform special projects and other duties as needed by the management team. • Maintain confidentiality at all times • Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards

Requirements

• High School Diploma or equivalent required • Medical Billing and Coding certification preferred, but not required • Experience in Hospital/Facility billing required • 4+ years' Medicare facility claims experience • Experience in the Inovolan, DDE and Finthrive systems preferred • 2-3 years’ experience in insurance collections, including submitting and following up on claims • Basic knowledge of healthcare claims processing including: ICD-9/10, CPT and HCPC codes, as well as UB-04 • Ability to use various workflow system and client host system such as STAR, SMS, EAGLE and EPIC, as well as other tools available to them to collect payments and resolve accounts • Epic experience preferred • Working knowledge of the insurance follow-up process with understanding of the fundamental concepts in healthcare reimbursement methodologies • Understanding of government, Medicare and Medicaid claims • Proficiency with Microsoft Office including Excel and Word • Ability to work well individually and in a team environment • Strong organizational, communication and written skills • Basic math and typing skills