GENERAL SUMMARY OF DUTIES:
The Patient Account Representative is responsible for monitoring and maintenance of Return to Practice functions, as well as seeing claims through from charge entry to full resolution.
DUTIES INCLUDE BUT NOT LIMITED TO:
Daily monitoring and resolution of outstanding outpatient billing claims
Working of various billing queues to resolve denials, demographic errors and other holds
Obtaining referral and surgery/procedure pre-authorizations from insurance companies, as needed
Entering of charges from practice encounter forms, as needed
Tracking of billing errors and their sources to ensure process improvement
Analyzing EOBs for accuracy when needed for claim resolution
Verifying insurance benefits when necessary for accurate claims processing
Daily depositing of cash/check payments from practices
Following up directly with payors regarding claims processing/payments
Communicating as a customer service/billing representative to patients to resolve billing questions
Periodic projects, as determined by supervising manager
Must read, understand, and adhere to all HealthONE Physician Care policies and procedures.
Practice and adhere to the Code of Conduct and Mission and Value Statement.
- Knowledge of basic office equipment including copier, fax machine, and computer.
- Skill in dealing with interpersonal issues and customer relations.
- Ability to handle multiple priorities at once with minimal supervision.
- Ability to comprehend and follow written and verbal instructions.
- Ability to organize and communicate clearly.
- Ability to maintain confidentiality of information.
- Current medical billing experience, including knowledge of ICD-9 and CPT coding practices
- Ability to work and participate in a team environment within and across departments.