Senior Patient Account Representative - Follow Up and Denials

***Ideal candidate will have experience with follow up and denials.****

General Description: Under general supervision, may participate in any or all aspects of the patient processing and accounts receivable functions of the organization including billing, charge entry, collection, registration, scheduling, follow-up, coding, payment posting and credit balance resolution. May reconcile daily IDX system receivables reports. May balance monthly transactions and provide summaries to faculty and department administration.

Essential Responsibilities:

• Patient scheduling

• Patient registration

  • Review patient admitting records and extracts relevant information

  • Records patient identification and demographic information in the computerized billing system

  • Contacts agency representatives to verify type and extent of coverage.

• Charge entry

  • Performs preliminary review of source documents to determine that sufficient data are present for processing

  • Using alphanumeric keyboard, transcribes and/or verifies data from source documents to the medium used for entering data into the computer

  • Batch charges

  • Generate cash totals

  • Enter charges

  • Balances batches by comparing batch proofs to source documents and hash totals

• Billing

  • Works with all areas of the organization in getting any necessary or requested documentation for patients, insurance carriers or other areas.

  • May interact with hospital patient accounting or records personnel to obtain patient demographic or other billing information

  • Operates hospital information system terminal to obtain patient demographic information, patient insurance information and status of approvals or denials

  • Completes processing of all inpatient and outpatient documents received on a daily basis

  • Assists in resolving department problems with IDX billing

  • Maintains records of charges, payments, third party charges, etc.

• Collection

  • Answers patient's questions regarding statements, agency coverage, etc.

  • Handles correspondence regarding collection activity and records results

  • Identify patient accounts for collection action when accounts become delinquent or when unable to contact patient or responsible party

  • May receive patient payments and/or issue payment receipts

• Coding

  • Record CPT codes on billing form

  • Record ICD-9 codes on billing form

• Follow-up

  • Initiates contact with patients and/or third party carriers if there is a delay in responding to statements or claims

  • May process incoming and outgoing mail

  • May receive incoming telephone calls and resolve issues communicated

  • Records results of mail and telephone contacts on the computer billing system

  • Contacts insurance carriers regarding non-payment and/or improper payment of claims

  • Reviews denials

  • Interfaces with patients, physicians, and others regarding professional billing operations and funds

• Payment posting

  • Post receipts to proper patient accounts

  • Posts denials

  • Compare batch proofs and source documents for accuracy

• Reporting

  • Assists in reviewing and balancing IDX transaction reports for administration

  • Reconciles daily IDX receivables reports

  • Prepares billing statements from statistical data

• Credit balance resolution

  • Review daily billing and accounts receivable credit balance reports

  • Prepare daily refund check requests

  • Prepare other daily credit balances other than refunds

  • Post refund checks to patient accounts

  • Mail refund checks with supporting documentation

General Responsibilities:

• Performs other duties as assigned.

Minimum Requirements:

Education: High School Diploma or GED.

Experience: 3-5 years of experience in Medical Billing, Medical Collections, Medical Billing Systems (IDX or other billing system) required.

Licensure/Certifications/Registrations Required:None required.

Knowledge, Skills, and Abilities:

• Attention to detail

• Excellent verbal and written communication skills

• Proficient with the use of Microsoft Office tools

#cb