What are the responsibilities and job description for the Patient Accounts Representative position at Community Memorial Hospital, Hamilton?
Be a part of the end-to-end Revenue Cycle Management process, including but not limited to eligibility, pre-certification, charge capture, billing, collections, and denials management.
Ensure accurate and timely submission of claims to insurance companies, government payers, and other third-party entities.
Perform regular audits and reviews of billing and coding practices to identify and resolve errors, compliance issues, and revenue leakage.
Collaborate with various departments, including finance, coding, compliance, and clinical teams, to optimize revenue cycle operations and streamline workflows.
Stay up to date with industry regulations, reimbursement policies, and coding guidelines to ensure compliance and maximize revenue opportunities.
Investigate and resolve complex billing and reimbursement issues, including appeals and disputes with payers.
Maintain accurate documentation of revenue cycle activities, audits, and compliance measures.
Qualifications Preferred
In-depth knowledge of healthcare reimbursement methodologies, coding systems, and best practices.
Must demonstrate a strong understanding of medical insurance billing and collections with CPT/HCPCS, ICD-10, coding, and medical terminology, as well as an overall understanding of managed care products.
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