Patient Accounts Representative – Hospital Prof Billing

Overview:

Job Description Summary:

Responsible for the timely processing of duties and/or activities related to the accurate processing and handling of patient accounts. Ensures that all patient account information, charges, billings, and follow-up activities are accurate, complete, and timely.

Job Description:

Essential Functions:

• Reviews patient account information for completeness and accuracy.
• Makes necessary changes/updates to patient account information to ensure timely payment on accounts. Retrieves status information from government and third party payers regarding outstanding professional claims.
• Coordinates with governmental agencies, third-party payers, and internal auditors to ensure maximum reimbursement for hospital services.
• Acts as a liaison between the hospital and third party payers in resolving billing and reimbursement issues.
• Provides follow-up on claim edits, rejections, denials, and outstanding professional claims in a timely manner.
• Maintains patient records and ensures confidentiality of sensitive information.

Education Requirement:

• High school diploma, required.
• Associates degree, preferred.

Licensure Requirement:

(not specified)

Certifications:

(not specified)

Skills:

• Knowledge of medical terminology, various claim forms, third party contracts and payment patterns, CPT and ICD9 coding, and reimbursement regulations and policies of third party payers.
• The ability to do data entry and work a calculator.
• Problem identification and problem solving skills,required.
• Excellent interpersonal, verbal, and written communication skills.
• Excellent organization skills and the ability to comprehend and follow written and verbal instructions.

Experience:

• Two years’ experience in medical billing, claims follow-up and customer service, required.
• One year experience working on a mainframe computer. Experience using Outlook, Word and Excel, required.

Physical Requirements:

OCCASIONALLY: Lifting / Carrying: 0-10 lbs, Lifting / Carrying: 11-20 lbs, Pushing / Pulling: 0-25 lbs, Reaching above shoulder, Squat/kneel, Standing, Walking

FREQUENTLY: Flexing/extending of neck, Patient Equipment, Peripheral vision

CONTINUOUSLY: Audible speech, Color vision, Computer skills, Decision Making, Depth perception, Hand use: grasping, gripping, turning, Hearing acuity, Interpreting Data, Problem solving, Repetitive hand/arm use, Seeing – Far/near, Sitting

Additional Physical Requirements performed but not listed above:

(not specified)

Accuracy and Attention to Detail – Working Knowledge (Meets Expectations), Data Entry Management – Basic Understanding (Meets Expectations), Effective Communications – Working Knowledge (Meets Expectations), Healthcare Information Systems – Working Knowledge (Meets Expectations), High School/GED, NCH Core Values – Basic Understanding (Meets Expectations), Problem Solving – Working Knowledge (Meets Expectations)

“The above list of duties is intended to describe the general nature and level of work performed by individuals assigned to this classification. It is not to be construed as an exhaustive list of duties performed by the individuals so classified, nor is it intended to limit or modify the right of any supervisor to assign, direct, and control the work of employees under their supervision. EOE M/F/Disability/Vet”

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