Sr. Patient Account Rep – Insurance and Follow Up – Non-Government – Full Time – Days

Sr. Patient Account Rep – Insurance and Follow Up – Non-Government – Full Time – Days

Requirements

• High School diploma.
• 1-3 years billing or follow-up experience in healthcare field.

Responsibilities

• Training and development of staff including creating, updating, and maintaining training manual.
• New hire training and feedback, assist staff with questions, taking ownership and finding the answer.
• Assist Supervisor as needed.
• Run daily WIP report and communicate any trends same day.
• Complete all assigned spreadsheets and reports timely.
• Contacts third party payers and guarantors electronically and via phone to resolve account balances on all assigned accounts.
• Works all correspondence within 24 hours or receipt. Detail notes regarding correspondence must be entered into the system.
• Works all denials within 48 hours of receipt taking whatever action may be required to obtain account resolution.
• Appeals all accounts denied for medical necessity, authorizations, length of stay and timely filing issues.
• Monitors all denials for trends and issues and reports finding to supervisor.
• Bills or re-bills, as necessary.
• Ensures the hospital is in compliance with all state and federal rules and regulations both billing and HIPAA.
• Assigned special projects will be completed within the time frames given.
• Facilitate and/or conduct training sessions and seminars offered by the Hospital and Third-Party Payers.
• Appropriately documents each account worked in patient accounting system.
• Reviews same day and 72-hour admission report to determine if accounts need to be combined.
• Makes necessary corrections in electronic billing system.
• Adjusts billings based on audits and or changes in diagnosis or DRG.
• Updates patient accounts with corrected demographic or insurance information.
• Posts adjustments.
• Calls insurance companies to obtain correct information when unable to identify if account payment is to be posted.
• Respond to all emails both internal and external in a professional and courteous manner and within 24 hours.
• Follows the mission state and values established by the facility.
• Stays current with HIM trends, relevant rules, regulations, and directives from regulatory agencies and third-party payers.

Preferred Qualifications

• Metrix system knowledge
• Waystar Billing System knowledge
• CPAR certification preferred.
• Excellent communication and interpersonal skills
• Experience with Microsoft Excel and Word.