Senior Patient Account Representative - Pre-Visit Services/Authorizations

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Remote Eligibility: Candidates must reside and work full-time in OK before their first day of employment.

SHIFT: M-F, Days. Will be required on-site as needed, at least monthly.

**The ideal candidate will have strong experience in handling authorizations and referrals, serving as the bridge between insurance companies and services provided for the patients we serve here at OU Health.**

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

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