Job Description

We are hiring for a Senior Patient Account Representative to assist with updating patient medical accounts and work closely with the rest of the team. The ideal candidate has excellent organizational skills, communication skills, and the desire and ability to learn quickly. Working as a part of a team to meet deadlines but also being able to work independently is crucial to the success in this position. We are looking for candidates who will actively exhibit Service Excellence, Transparency, Teamwork, Accountability, Hard Work, and a Positive Attitude in their job.

Job Responsibility

• Understanding of various insurance carriers, including Medicaid, Medicare, HMOs, Workers Compensation, No Fault, contracted and non-contracted plans.
• Maintaining patient records, which includes detailing patient demographics as well as updating payment and medical insurance information.
• Processing patient payments and refunds.
• Identifying medical coding mistakes, as well as patient underpayments or overpayments and rectifying them accordingly.
• Communicating with medical insurance providers to verify eligibility, payments, and denials.
• Sends supporting documentation to various government sites.
• Manages work queue, aging lists, reports, and claims correspondence to assure accurate and timely payment of accounts.
• Verifies completeness and accuracy of billing data and revises any errors.
• Review and respond to third party, integrity, and special audits.
• Ability to work in a fast-paced environment with demonstrated ability to prioritize multiple, competing tasks and demands, and to seek supervisory assistance as appropriate.
• Review the status of the entire patient account and exercise judgment to determine appropriate course of action for resolution.
• Ability to adjust, void and submit bills through scrubbing system.
• Other related duties as assigned.
• Interfaces with physicians and administrators to ensure financial growth and stability; apprises physicians of new and revised procedures.
• Monitors accuracy of fee structure and reimbursement payment schedules from third party payers, all cash payment deposits and refunds.
• Acts as resource person for resolution of complex billing situations.
• Guides billing/clerical staff regarding billing and office/clerical functions.
• Coordinates clinical documentation requests to business office to ensure timely appeals.
• Develops and implements policies and procedures to facilitate billing and maximize case collections.
• Reviews and recommends improvements for financial management of each billing area.
• Performs related duties as required. All responsibilities noted here are considered essential functions of the job under the Americans with Disabilities Act. Duties not mentioned here, but considered related are not essential functions.

Job Qualification

• Associate's Degree required, or equivalent combination of education and related experience.
• 3-5 years of relevant experience, required.

Preferred Qualifications

• Experience in accounts receivable, customer service, or a related professional office environment
• Knowledge of medical terminology and billing
• Knowledge of Hospital Systems, including Invision, SSI, MRT, Eagle, Keane, Soarian, Myability and AEOS.
• Knowledge of HMS, OMIG, RAC, and OIG audits.
• Same Posting Description for Internal and External Candidates
• Strong verbal and written skills
• Excellent organization, time management, and prioritization skills
• Research capabilities when confronted with an issue
• A positive and friendly attitude

*Additional Salary Detail
The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. When determining a team member's base salary and/or rate, several factors may be considered as applicable (e.g., location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget and internal equity).