Job Description

Under the direction of the Revenue Cycle Manager and Supervisor, the Patient Account Representative is responsible for monitoring insurance claims due to no response, pending response, denial and appeal, and proactively resolve balances billed to insurance carriers by way of accurate claim adjudication. This position may also evaluate and resolve under or over payments and requests for refund from insurance carriers and other duties as assigned.

A demonstrated knowledge of the Healthcare Revenue Cycle is required with experience in medical billing and/or insurance reimbursement methods. Prior experience in the Physician Revenue Cycle.

LOCATION AND YEARS OF EXPERIENCE:
While the position is primarily remote (work from home), o n occasion it may be required to work in a normal office environment or travel to the various hospitals and work locations will be necessary. Work hours may vary from time to time depending upon the needs of the business. Regular and predictable attendance is required for this position for both remote and in office duties

Knowledge Required:

Understanding of Healthcare Revenue Cycle

Understanding of the CMS-1500 claim form and required components

Understanding of basic coding requirements of the CMS-1500 claim form.

Ability to read and understand the Insurance Explanation of Benefits

Minimum Required: High School Diploma or GED | LICENSE & CERTIFICATION: N/A.

Minimum Required: 2 years in a Healthcare Revenue Cycle with demonstrated knowledge of coding concepts, medical billing, insurance reimbursement methods and/or Follow-up of unpaid, underpaid, payment reversal or denied claims. Experience with Epic Revenue Cycle or other HealthCare operating system applications. Experience in various Payer Portals and searching regulatory systems.

Experience in Physician Revenue Cycle preferred.

REQUIRED -

Comprehensive understanding of the Healthcare Revenue Cycle. Experience with basic Medicare, Medicaid and Commercial billing, coding, and compliance rules. Application of analysis methods. Application of effective research and organizational skills. Experience with MS suite of products with emphasis in Excel.

SKILLS: To be successful in this role, the following skills should be present:

• Ability to self-manage & work independently in a remote environment using successful organizational methods.
• Ability to prioritize tasks in a fast paced and occasional stressful environment.
• Demonstrated verbal and written communication skill. Incorporates acceptable email etiquette.
• Analytical and problem-solving; possessing good judgement and capable of making occasional independent decisions based on provided report requirements.
• Flexible. Willing to accept changing demands. Works well under pressure in a diplomatic and expeditious manner.
• Team oriented. Works professionally and cooperatively with others.
• Attention to detail: Consistently practices accurate documentation. Records research and actions thoroughly in an abbreviated, comprehensive manner.
• Computer literate. Comfortable with learning and using software applications.