Patient Account Representative II - Patient Billing Services
- Arizona
- Permanent
- Full-time
Responsible for all or part of the following: billing and collecting, research, correspondence, payment and adjustment posting, charge entry, prior authorization, and a host of other duties to assure timely reimbursement to the medical provider. Demonstrates independent problem-solving skills of account error necessary to bring the account balance to zero within established time frames.
Essential Functions
- Responsible for research and secure payment for insurance accounts:
Submit appeal letters on unpaid and underpaid claims
Participate in accounts receivable collections projects as needed to meet department goals
Contact insurance companies to follow up on denials and correspondence
Contact patients regarding insurance related issues
Research recoups and repayments to assure that payments are accurate and comply with Medicare and Managed care contracts payment methodologies
Work the electronic denial file (835b) to ensure clean claim submission
Review Charge review work queues as assigned * Responsible for research and secure payment for patient balances:Follow up required daily accounts based on account work queue assignment to reduce the cash pays A/R
Submit final letters to delinquent accounts
Answer incoming patient calls
Provide support to the clinics as needed during patient care hours
Collection calls to patients to collect past due balances
Process credit card payments and post within the patient billing system
Set up payment plans for patients
Review statements to ensure accuracy
Acts as a liaison between patient, practice and insurance carrier regarding complaints and problems
Work with statement and bad debt vendors on disputes and ensure accuracy of accounts
Work return mail to update accounts to ensure accuracy * Performs routine data entry and/or review of claim edit work queues:Input charges for physician billing
Correct denials that have dropped to the claim edit work queues timely
Maintains current knowledge of regulatory billing requirements for the specified payers and various specialty specific limitation or payer expectations
Process the electronic claims batch daily and initiate the printing of paper claims
Review Charge review work queues as assigned * Handles all payments and correspondence received in the central business officeProcesses all EFT/ERA, lockbox, mail, POS, phone payments.
Processes credit cards
Creates payment batches and scans all correspondence into patient billing system
Processes deposits for all incoming payment, including POS from multiple clinics
Sets up courier service for new clinics
Posts payments and denials into patient billing system
Processes ERA payments and works error work queue
Performs daily batch reconciliation
Follow up on credit work queues to maintain the undistributed credits, process refunds and research incorrect adjustments or payments * Follows departmental functions:Prioritize work to minimize interruptions and increase efficiency in collections process
Participate in daily DMS huddle, and all department meetings
Provide five-star customer service, to include patients, coworkers, vendors and management
Establish and maintain and efficient filing system
Maintain clean and organized work area
Communicates and engages effectively with others
Communicates and participates in training classes as needed to keep current with daily operations
Work in a team environment and participate in constructive feedback
Ability to handle numerous tasks simultaneously and with flexibility Education
- High School Diploma or GED - Required
- 2 years healthcare billing and collections experience in a medical practice or healthcare organization - Required
- 5 years healthcare related medical professional billing and collections experience. - Preferred