What are the responsibilities and job description for the Patient Account Representative position at Silver Cross Hospital?
Silver Cross Hospital is an extraordinary place to work. We're known for our culture of excellence and delivery of unrivaled experiences for our patients, their families, the communities we serve...and for each other. Come join us! It's the way you want to be treated.
Job Summary :
Review and process claims to Medicare and Medicare Advantage Payers in accordance with CMS regulatory guidelines. Analyze and correct rejections received from Payer or hospital system reports. Follow-up on related correspondence received in the office. Handle or redirect incoming departmental calls. Interact effectively with co-workers. Other general office duties as assigned.
Essential Duties and Responsibilities :
- Process all electronic and paper claims for Medicare and Medicare Advantage billing according to CMS and Payer specific guidelines.
- Ability to understand CMS Rules and ensure the Hospital is compliant with billing.
- Understand additional billing requirements enforced by Medicare Advantage Payers.
- Identify and process LMRP and CCI edits as established.
- Ability to identify and understand Medical Policy established by CMS.
- The ability to analyze if CPT coding needs additional modifiers or codes to support procedure for billing.
- Review, correct, and process rejections received from Payers.
- Review and correct rejections in hospital system preventing claims from billing.
- Review Medicare EOBs and process adjustments as established by workflow.
- Ability to use Experian billing software and CMS DDE system.
- Inform Management of payer trends related to billing or Facility trends preventing claims from process first time billed.
- Process patient and insurance correspondence for assigned carriers.
- Review and process requests from various areas regarding billing questions on Worklists.
- Answers patient and insurance calls regarding claims.
- Perform basic computer functions for Microsoft office.
- Maintain excellent customer service skills.
- Provides the highest standard of privacy and confidentiality in matters involving patients, coworkers, and the hospital by abiding by the Standards of Conduct.
Work Shift Details :
Days, Days; Monday - Friday
Department : PATIENT ACCOUNTS
Benefits for You
At Silver Cross Hospital, we care about your health and well-being and that is why we work hard to provide quality and affordable benefit options for you and your eligible family members.
Silver Cross Hospital and Silver Cross Medical Groups offer a comprehensive benefit package available for Full-time and Part-time employees which includes :
Silver Cross Management Services Org. - Premier Suburban Medical Group benefits offered to Full-time and Part-time employees include :
Registry employees who meet eligibility may participate in one of our 401(k) Savings plan with a potential match. However,registry employees are ineligible for Health and Welfare benefits.
The expected pay for this position is listed below :
17.99 - $22.48
The final offered salary will take several factors into consideration, including but not limited to : licensure, certifications, work experience, education, knowledge, demonstrated abilities, internal equity, market data, and more.
Salary : $18 - $22
