Account Representative.

Position Summary:

Under the general supervision of the Dental Director or the Support Staff Supervisor, the Account Representative is responsible for the billing, collection, and reconciliation of accounts, and educating related departments about the billing/collection/reconciliation processes to ensure that clean, collectible claims are sent to payers in a timely manner.

This list of duties and responsibilities is illustrative only of the tasks performed by this position and is not all inclusive.

Essential Duties & Responsibilities:

• Review patient’s accounts to determine the status of the account.

• Make standard adjustments.

• Prepare and process a variety of documents necessary for the maintenance and followup of all outstanding patient’s accounts.

• Examine accounts for accuracy, adequate documentation, and compliance with regulations.

• Telephone third party payers regarding amounts that are due.

• Perform follow-up procedures in a timely manner in accordance with hospital Business Office policy and procedures.

• Generate contractual adjustment documents, when appropriate.

• Identify accounts that are deemed non-collectible and make appropriate adjustments.

• Report any discrepancies to the Dental Director providing all supporting documents and recommending resolution.

• Generate monthly reports and close month by the first week of the following month and submit to the Finance Department.

• Help with Dental Receptionists, as needed.

• Perform other duties as assigned.

Knowledge, Abilities, Skills, and Certifications:

• Knowledge of Medical and Dental Terminology.

• Knowledge of ICD-9, CDT coding and ICD-10.

• Ability to organize and keep records/files, MS Office Programs.

• Knowledge and understanding of Third-Party reimbursement/claims processing and follow up processes.

• Knowledge of the Meditech computer system, Dentrix dental software, and MS Office.

• Ability to read and understand aging reports and use them to target accounts for concentrated collection efforts.

• Ability to exchange ideas and information in a timely, concise, effective, and interpersonally appropriate manner.

• Demonstrate action and behavior that contribute to creating an environment where all individuals are treated in accordance with the mission & value statement.

• Ability to model Sage Memorial Hospital mission, values, and ethical standards and to perform work responsibilities in an effective, timely and efficient manner.

• Ability to understand departmental and organizational goals and to effectively prioritize and perform work responsibilities in a manner which best achieves those goals.

• Knowledge of the Joint Commission, HIPAA, Federal State and Local regulations including Workers Compensation and OSHA regulations.

• Ability to perform tasks without constant supervision, the delivery of assigned work on a timely basis, and follow-up of all assignments, on a timely basis.

• Ability to ensure neatness, completeness, thoroughness and organization of work and work habits. This work must be completed without errors or omission.

• Ability to speak the Navajo language and/or a familiarity with the Navajo Way.

Physical Demands:

While performing the duties of this job, the employee regularly is required to sit; use hands to reach and grasp objects; reach with hands and arms; and talk or hear. The employee frequently is required to walk. The employee occasionally is required to stand; and stoop, kneel, crouch, or crawl. The employee must occasionally lift and/or move up to 50 pounds.

Work Environment: The employee will work in a Patient Care/Office Environment with moderate noise level. Normal scheduled hours are four, 10-hour shifts: Monday – Thursday or Tuesday – Friday.