High School Diploma/GED
Minimum of 3 years of experience
SUMMARY: The Patient Accounts Representative III is responsible for billing and collecting third party balances for services provided to patients rendered services within the Physician Services Medical Staff through the Billing Department. The Representative identifies areas where consistent payment delays, claim denials, or reduced payment are occurring and works with physicians and administrators to resolve associated deficiencies.
Principle Duties and Responsibilities:
1. Receives incoming telephone inquires from patients/guarantors and/or insurance carriers. Responds to information and documentation requests. Solicits payment of outstanding balances. Authorizes monthly payment arrangements or assists patients/guarantors in applying for financial assistance.
2. Reviews explanation of benefit and correspondence received from third party payers. Works the electronic rejection report from the automated patient accounting system. Addresses incorrect payments and denials. Responds to requests in a timely manner
3. Collects from third party payers based on entries, which appear in accounts receivable reports. Contacts third party payer representatives via telephone, e-mail, fax, web site and written correspondence.
4. Maintains an extensive knowledge base pertaining to assigned third party payers. Visits third party payer web sites frequently to obtain updated information. Remains current on third party regulations and claim submission requirements. Partners with Physician Services Billing Management to address coding related deficiencies, which result in claim denials, processing delays and reduced reimbursement.
5. When assigned, enters all patient charges and demographic data into physician practice management system accurately and timely to ensure all services are billed to appropriate insurance carrier and/or patient.
6. Achieves monthly goal set by Physician Services Billing Management in order to ensure optimal revenue is captured for the organization.
Required Education: High School diploma or equivalent.
Required Experience: Three to Four years in a medical billing and/or collections environment.
Saint Agnes Hospital - 16 months ago