Job Description

This position primarily involves following up on accounts for services rendered at Williamson Health. This is to maximize the full payment potential of each claim from the Commercial, Government and Auto Liability carriers in a timely and accurate manner. The Patient Account Rep serves as a liaison between the patients and insurance carriers. The PAR works with all departments in the hospital to ensure the proper charges, adjustments and codes are processed by the carriers and the patient’s balance is correct. This position also serves as a fill in for the Commercial/Government Biller whenever needed.

POSITION REQUIREMENTS

Formal Education / Training:
Must be a high school graduate or equivalent, have hospital and physician billing experience, have PC and calculator experience, and have good communication skills to discuss account financials with insurance carriers and patients.

Workplace Experience:
Prior experience in a hospital setting or related area is required. Working knowledge of DDE and EServices strongly preferred. Home Health, Hospice and SNF follow-up experience preferred, but not required.

Equipment and Skills Training:
Meditech System, SSI Electronic Billing System, SSI Electronic System for RA Print, FIND IT, Experian, Blue Cross, DDE System, Payer Websites, Excel, Word, PC, Printers, Fax, Copier

Physical Environment:
Business Office

Physical Effort:
Requires sitting for prolonged periods of time, viewing the computer screen and using repetitive motions, and must have a clear, understandable telephone voice

PERFORMANCE STANDARDS

1. Utilizes SSI Electronic software (when necessary) to accurately process all Medicare and Medicare Managed Care accounts assigned by system daily
2. Processes Medicare and Medicare Managed Care paper claims when necessary
3. Compares SSI electronic claim against Meditech claim when dealing with Medicare questions regarding claim submitted and works on resolving discrepancies to prevent denial.
4. Utilizes Medicare’s Direct Data Entry (DDE) system to access information such as claim status inquiry, eligibility, daily Medicare check amounts, etc.
5. Analyzes Medicare EOBs and remittances for secondary insurance filing and to determine appropriate patient liability or secondary payer amount
6. Utilizes Outlook to communicate denials with the various departments as well as Passport and Medicare Managed Care websites for information necessary for account processing.
7. Completes review of assigned Medicare accounts utilizing ATB (current account balance) reports and/or Collector Desktop list as needed for account processing in a time frame that is consistent with peers.
8. Converses and documents all discussions with Medicare and Medicare Managed Care payers regarding unpaid claims
9. Answers patient calls regarding billing and account balances for all Medicare/MCR Managed Care accounts
10. Re-queues Medicare/MCR Managed Care claim forms and itemized bills as needed after audit corrections have been completed
11. Handles and prioritizes multiple tasks
12. Completes any other job duties assigned by the department Director or Supervisor(s)

About Us

Williamson Health is a regional healthcare system based in Williamson County, Tennessee, with more than 2,500 employees across more than 30 locations and more than 860 physicians and advanced care practitioners offering exceptional healthcare across 60-plus specialties and subspecialties close to home. The flagship facility, Williamson Medical Center, a 337-bed facility which recently opened its new Boyer-Bryan West Tower, offers extensive women's services, state-of-the-art cardiology services, advanced surgical technologies, an award-winning obstetrics and NICU, leading-edge orthopaedics, outpatient imaging services, and distinct comprehensive emergency and inpatient services for both adult and pediatric patients. Other Williamson Health service providers include the Bone and Joint Institute of Tennessee, The Turner-Dugas Breast Health Center, Monroe Carell Jr. Children's Hospital Vanderbilt at Williamson Medical Center, Williamson Health physician practices that are strategically located throughout the community, countywide Emergency Medical Services that include 18 rapid response units, Williamson Health Foundation, and multiple joint venture Vanderbilt Health and Williamson Medical Center Walk-In Clinics in Williamson County. Learn more about our many specialized services at WilliamsonHealth.org.

Williamson Health is a system where your talents will be valued and your skillset expanded. We are rooted in our promise to world-class, compassionate care for the residents of Williamson County and surrounding communities, taking exceptional pride in serving our community. We're committed to empowering our employees to work in innovative ways and reserve time and space for curiosity, laughter and creativity. We value and support the diversity and cultural differences among one another and are committed to upholding an inclusive environment that appreciates the uniqueness of all individuals. Our values are at the heart of everything we do: respect for every individual, the health and total well-being of all people, human compassion and integrity. These shape who we are as an organization and are essential for delivering the highest level of culturally competent care and treatment of every patient, family member, visitor, physician and employee.

Company Culture:
We are passionate about the care we offer and also our standards of performance which include compassion, respect, accountability and safety -- toward our patients and also toward our colleagues. We're looking for talented, caring, and mission-minded professionals who view their career in healthcare as more than just a paycheck, but as a true calling. We are proud of our unique culture that balances doing what we love, working alongside a supportive team, and maintaining a good quality of life - all while making a difference no matter your department or position.

Community Overview:
Franklin sits in the heart of Williamson County, which has the top-rated school system in the state, a plethora of parks and green spaces, fabulous restaurants, a rich traditional of hospitality, and of course, world-class healthcare. Various publications have showered Franklin with such accolades as one of the "Best Southern Towns," "Best Place to Live," "Top 10 Community for Job Growth," and "Top 50 Cities to Start a Small Business."