Patient Account Representative/Hospital Billing - Remote

Job Purpose
The Patient Account Representative is responsible for collections, account follow up, billing allowance posting for the accounts assigned to them.

Duties and Responsibilities

• Transcribe patient information from client/hospital records, calculate totals, net amounts, and discounts, and enter electronic billing system.
• Review, edit, and rebill claims and diagnosis codes previously entered the systems; identify technical problems and report them to clearing house or computer operators
• Operate electronic billing system to process insurance claims and system reports; audit items produced for completion and accuracy and prepare for mailing/distribution
• Route claims for appropriate insurance or patient follow-up
• Assist in transmitting claims and downloading files into the Electronic Billing system and clearing house
• Initiate communication with Liaisons and member hospital representatives to confirm data and resolve claims discrepancies
• Follow-up with payers to ensure timely resolution of all outstanding claims, via phone, emails, fax or websites
• Review and updates all patient and financial information accurately as given
• Verify that information is accurate as to individual or insurance company responsible for payment of bill
• Monitor all billings for accuracy, updating any that contain known errors
• Monitor Medicaid/healthy options coupons to assure services are billed within expected timeframes
• Bill all hospital services to primary insurer or patient correctly and within expected timeframe
• Follow up with insurance companies on all assigned accounts within expected timeframe
• Explain hospital regulations with regard to methods for payment of accounts and maintains complete working knowledge of insurance regulations and hospital insurance contracts
• Identify and report underpayments and denial trends
• Analyze, identify and resolve issues causing payer payment delays; Initiate appeals when necessary
• Manipulate excel spreadsheets and communicate results
• Meet and maintain daily productivity and quality standards established in departmental policies
• Act professionally, cooperatively and courteously with patients, insurance payors, co-workers, management and clients
• Perform special projects and other duties as needed by the management team
• Maintain confidentiality at all times
• Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards

Qualifications

• High School Diploma or equivalent required
• Medical Billing and Coding certification preferred, but not required
• Experience in Hospital/Facility billing required
• Knowledge of insurance collections, including submitting and following up on claims
• 2 years Billing experience required
• Working knowledge of CPT codes and statement preparation
• Strong working knowledge of electronic billing systems and statement preparation
• Knowledge of healthcare claims processing including: ICD-9/10, CPT and HCPC codes. UB04 experience required.
• Ability to use various workflow system and client host system such as STAR, SMS, EAGLE and EPIC, as well as other tools available to them to collect payments and resolve accounts
• Knowledge of FinThrive system a plus
• Working knowledge of the insurance follow-up process with understanding of the fundamental concepts in healthcare reimbursement methodologies
• Understanding of government, Medicare and Medicaid claims
• Proficiency with Microsoft Office including Excel and Word
• Ability to work well individually and in a team environment
• Strong organizational, communication and written skills
• Basic math and typing skills

Working Conditions

• Physical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear.
• Mental Demands: The employee must be able to follow directions, collaborate with others, and handle stress.
• Work Environment: The noise level in the work environment is usually minimal.

Med-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non-merit based factors, or any other characteristic protected by federal, state or local law.